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PHARMACOLOGICAL SUPPORT IN LASER TREATMENT OF
PEDIATRIC SECONDARY CATARACTS: COMPLICATION
PREVENTION
Kariyev Abdufarrux Varisovich
Zokirkhuzhaev Rustam Asrolovich
Children's National Medical Center
Doctor of Medical Sciences, Associate Professor Tashkent Medical Academy
https://doi.org/10.5281/zenodo.15280965
Abstract
This study analyzes the effectiveness of pharmacological support in
preventing complications during Nd:YAG laser treatment of secondary cataracts
in children. A total of 80 children (160 eyes), aged 6 months to 12 years, were
examined post-cataract surgery. A standardized postoperative regimen was
used: dexamethasone 0.1% (4×/day), NSAIDs (2×/day), and tropicamide
(1×/day for 7 days). In 93.1% of cases (149 eyes), the optical axis remained
clear at 12 months. Postoperative complications occurred in 9.3% of eyes:
increased IOP in 6.2%, transient uveitis in 3.1%. Timely medication significantly
reduced risks and ensured visual rehabilitation. Individualized management
enhances the safety and success of treatment.
Keywords:
secondary
cataract,
Nd:YAG
laser,
pediatric
ophthalmology,
pharmacological prophylaxis, postoperative inflammation, intraocular pressure,
complication prevention
Relevance
Secondary cataracts are common in children after congenital or
developmental cataract surgery, with an incidence of up to 60–80%. Nd:YAG
laser capsulotomy is a minimally invasive and effective approach for restoring
visual axis clarity. However, in pediatric patients, especially those under 5 years
old, the procedure carries risks of postoperative inflammation, increased
intraocular pressure (IOP), and recurrence of fibrosis. A tailored
pharmacological strategy is essential to prevent such complications. Currently,
there is a lack of standard protocols addressing medication timing, dosage, and
duration for children. This study evaluates a structured medication regimen in a
large pediatric cohort to establish clinical efficacy and safety. The results provide
valuable insights for ophthalmologists in optimizing postoperative care.
Effective pharmacological management can minimize complications and
improve long-term visual outcomes, thus representing a critical component of
pediatric secondary cataract treatment. The relevance is underscored by the
CURRENT APPROACHES AND NEW RESEARCH IN
MODERN SCIENCES
International scientific-online conference
198
need for standardized preventive approaches in laser interventions among
children.
Aim:
To evaluate the effectiveness of a standardized pharmacological protocol
in preventing complications following Nd:YAG laser capsulotomy in children
with secondary cataracts.
Materials and Methods
A prospective study involved 80 pediatric patients (160 eyes) aged 6
months to 12 years (mean age 4.6 ± 2.8 years), all of whom had secondary
cataracts after primary cataract extraction. All patients received a uniform
pharmacological regimen post-laser: dexamethasone 0.1% eye drops (4×/day),
NSAIDs (2×/day), and tropicamide 1% (1×/day for 7 days). Nd:YAG laser
parameters varied based on age and fibrosis density. Follow-ups were
conducted at 1, 3, 6, and 12 months post-treatment. Outcomes included best-
corrected visual acuity, optical axis clarity, IOP, and inflammation rate. Data
were statistically processed using Student’s t-test and chi-square, with
significance at p<0.05.
Results
At the 12-month follow-up, 93.1% (149 eyes) retained a clear optical axis.
Best-corrected visual acuity improved by ≥2 Snellen lines in 90% (144 eyes).
Complications occurred in 15 eyes (9.3%): transient IOP elevation in 10 eyes
(6.2%) and mild anterior uveitis in 5 eyes (3.1%). No cases of IOL damage or
retinal detachment were noted. The medication protocol significantly lowered
the risk of inflammation (p = 0.01) and IOP spikes (p = 0.03) compared to
historical controls without standardized prophylaxis. Patients aged under 3
required extended anti-inflammatory treatment. Medication adherence was
98%, contributing to improved safety and outcomes.
Conclusion
Standardized pharmacological prophylaxis significantly reduces
complications associated with Nd:YAG laser capsulotomy in children with
secondary cataracts. The study confirms the efficacy of dexamethasone, NSAIDs,
and mydriatics in minimizing postoperative inflammation and IOP elevation.
With a 93.1% rate of preserved optical axis clarity and only 9.3% complication
rate, the protocol ensures visual rehabilitation and enhances surgical safety.
This regimen should be considered as a routine adjunct to laser intervention in
pediatric ophthalmology. Early implementation and age-specific adjustments
improve tolerability and outcomes. Future multicenter studies may help
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optimize treatment duration and tailor protocols for different cataract etiologies
and age groups.
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Kariev A. V., Buzrukov B. T., Boltaeva G. U. Vestnik TGU //Annals of TGU. –
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Кариев А. В., Хамраева Л. С., Алимова Г. А. Лазерное лечение
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Кариев А. В., Хамраева Л. С., Алимова Г. А. Лазерное лечение
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