Authors: Vishaal Bhambhwani, Sina Khalili, Nasrin Tehrani, Asim Ali, Kamiar Mireskandari

Author Disclosure Block: V. Bhambhwani: None. S. Khalili: None. N. Tehrani: None. A. Ali: None. K. Mireskandari: None.

Abstract Body:

Purpose: SBCS has been viewed with caution by the ophthalmology community, especially due to risk of devastating complications in both eyes. There is paucity of literature on the subject in children, for whom significant benefits can be derived by operating both eyes under the same anaesthesia. The purpose of our study is to analyse outcomes and complications of SBCS performed in children at our centre over a period of ten years. 

Study Design: Retrospective cohort study. 

Methods: Retrospective analysis of records of children who underwent SBCS from 2008-2018 at a single institute was performed. Procedures were consented to by parents following detailed discussion about risks and benefits of surgery in two sessions versus one. Data on outcomes and complications (ophthalmological, anaesthesia-related) up to 8 weeks post-operative is presented. 

Results: 37 patients (74 eyes) (mean age 4.4 months) (21 Females, 16 Males) underwent bilateral lens aspiration with anterior vitrectomy (6 with, 68 without IOL). Contact lenses/glasses were used for post-operative visual rehabilitation.Average ASA score was 2.1 (1-4). 19 were admitted for observation overnight post-surgery (as per anesthesia protocol). There were no devastating anesthesia-related complications; however, one with aortic stenosis needed phenylephrine support, one was managed with re-intubation (laryngeal spasm post-operative) with no further complications. Average 3.89 post-operative follow-up visits (in 8 weeks post-operative) occurred. One patient had fibrinous reaction and another had glaucoma (needing goniotomy) in both eyes associated with Wolfram and Lowe syndromes, respectively. One eye had an epithelial defect, which resolved spontaneously. All eyes had clear visual axis at the end of follow up period. There was no endophthalmitis. 

Conclusions: SBCS in children have several potential advantages including avoidance of multiple anaesthesia, faster visual rehabilitation, reduced post-operative follow-up visits, and cost savings to parents and healthcare systems. Outcomes and complication rates of SBCS in this study were comparable to reported literature for unilateral procedures. SBCS in children may be offered to parents as a viable option; however, studies with larger sample sizes are desirable.