Updates on managements of pediatric cataract.
Intraocular lens
Lensectomy
Pediatric cataract
Journal
Journal of current ophthalmology
ISSN: 2452-2325
Titre abrégé: J Curr Ophthalmol
Pays: India
ID NLM: 101678509
Informations de publication
Date de publication:
Jun 2019
Jun 2019
Historique:
received:
01
12
2017
revised:
02
11
2018
accepted:
14
11
2018
entrez:
19
7
2019
pubmed:
19
7
2019
medline:
19
7
2019
Statut:
epublish
Résumé
A comprehensive review in congenital cataract management can guide general ophthalmologists in managing such a difficult situation which remains a significant cause of preventable childhood blindness. This review will focus on surgical management, postoperative complications, and intraocular lens (IOL)-related controversies. Electrical records of PubMed, Medline, Google Scholar, and Web of Science from January 1980 to August 2017 were explored using a combination of keywords: "Congenital", "Pediatric", "Childhood", "Cataract", "Lens opacity", "Management", "Surgery", "Complication", "Visual rehabilitation", and "Lensectomy". A total number of 109 articles were selected for the review process. This review article suggests that lens opacity obscuring the red reflex in preverbal children and visual acuity of less than 20/40 is an absolute indication for lens aspiration. For significant lens opacity that leads to a considerable risk of amblyopia, cataract surgery is recommended at 6 weeks of age for unilateral cataract and between 6 and 8 weeks of age for bilateral cases. The recommended approach in operation is lens aspiration via vitrector and posterior capsulotomy and anterior vitrectomy in children younger than six years, and IOL implantation could be considered in patients older than one year. Most articles suggested hydrophobic foldable acrylic posterior chamber intraocular lens (PCIOL) for pediatrics because of lower postoperative inflammation. Regarding the continuous ocular growth and biometric changes in pediatric patients, under correction of IOL power based on the child's age is an acceptable approach. Considering the effects of early and late postoperative complications on the visual outcome, timely detection, and management are of a pivotal importance. In the end, the main parts of post-operation visual rehabilitation are a refractive correction, treatment of concomitant amblyopia, and bifocal correction for children in school age. The management of congenital cataracts stands to challenge for most surgeons because of visual development and ocular growth. Children undergoing cataract surgery must be followed lifelong for proper management of early and late postoperative complications. IOL implantation for infants less than 1 year is not recommended, and IOL insertion for children older than 2 years with sufficient capsular support is advised.
Identifiants
pubmed: 31317088
doi: 10.1016/j.joco.2018.11.005
pii: S2452-2325(17)30240-8
pmc: PMC6611931
doi:
Types de publication
Journal Article
Review
Langues
eng
Pagination
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