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Surgical Management of Pediatric Cataract

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Atlas of Pediatric Cataract

Abstract

The aim of surgery is not just to clear visual axis but also to maintain clear visual axis for a long time. Success of pediatric cataract surgery depends on meticulous surgery, close follow-up, and compliance to visual rehabilitation aids. Surgery is not required in all cases of cataract. It is recommended in visually significant cataract >3 mm [1], dense nuclear or posterior cataracts, cataracts not permitting fundus evaluation, and those associated with nystagmus or strabismus.

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References

  1. Vasavada AR, Nihalani BR. Pediatric cataract surgery. Curr Opin Ophthalmol. 2006;17:54–61.

    PubMed  Google Scholar 

  2. Beck AD, Freedman SF, Lynn MJ, Bothun E, Neely DE, Lambert SR. Glaucoma-related adverse events in the infant Aphakia treatment study: 1-year results. Arch Ophthalmol. 2012;130:300–5.

    Article  Google Scholar 

  3. Freedman SF, Lynn MJ, Beck AD, et al. Glaucoma-related adverse events in the first 5 years after unilateral cataract removal in the infant Aphakia treatment study. JAMA Ophthalmol. 2015;133:907–14.

    Article  Google Scholar 

  4. Birch EE, Stager DR. The critical period for surgical treatment of dense congenital unilateral cataract. Invest Ophthalmol Vis Sci. 1996;37:1532–8.

    CAS  PubMed  Google Scholar 

  5. Hartmann EE, Lynn MJ, Lambert SR. Infant Aphakia treatment study G. Baseline characteristics of the infant aphakia treatment study population: predicting recognition acuity at 4.5 years of age. Invest Ophthalmol Vis Sci. 2015;56:388–95.

    Article  Google Scholar 

  6. Khokhar SK, Pillay G, Dhull C, Agarwal E, Mahabir M, Aggarwal P. Pediatric cataract. Indian J Ophthalmol. 2017;65(12):1340–9.

    Article  Google Scholar 

  7. Gayer S, Tutiven J. Anesthesia for pediatric ocular surgery. Ophthalmol Clin North Am. 2006;19(2):269–78.

    PubMed  Google Scholar 

  8. Bar-Sela SM, Spierer A. Astigmatism outcomes of scleral tunnel and clear corneal incisions for congenital cataract surgery. Eye (Lond). 2006;20:1044–8.

    Article  CAS  Google Scholar 

  9. Matsumoto Y, Hara T, Chiba K, et al. Optimal incision sites to obtain an astigmatism-free cornea after cataract surgery with a 3.2 mm sutureless incision. J Cataract Refract Surg. 2001;27:1615–9.

    Article  CAS  Google Scholar 

  10. Wilson ME Jr. Anterior lens capsule management in pediatric cataract surgery. Trans Am Ophthalmol Soc. 2004;102:391–422.

    PubMed  PubMed Central  Google Scholar 

  11. Krag S, Olsen T, Andreassen TT. Biomechanical characteristics of the human anterior lens capsule in relation to age. Invest Ophthalmol Vis Sci. 1997;38:357–63.

    CAS  PubMed  Google Scholar 

  12. Taylor D. Choice of surgical technique in the management of congenital cataract. Trans Ophthalmol Soc U K. 1981;101:114–7.

    CAS  PubMed  Google Scholar 

  13. Wilson ME, Saunders RA, Roberts EL, et al. Mechanized anterior capsulectomy as an alternative to manual capsulorhexis in children undergoing intraocular lens implantation. J Pediatr Ophthalmol Strabismus. 1996;33:237–40.

    CAS  PubMed  Google Scholar 

  14. Comer RM, Abdulla N, O’Keefe M. Radiofrequency diathermy capsulorhexis of the anterior and posterior capsules in pediatric cataract surgery: preliminary results. J Cataract Refract Surg. 1997;23(Suppl 1):641–4.

    Article  Google Scholar 

  15. Kloti R. Anterior high frequency capsulotomy. I. Experimental study. Klin Monbl Augenheilkd. 1992;200:507–10.

    Article  CAS  Google Scholar 

  16. Fugo RJ, Delcampo DM. The Fugo blade: the next step after capsulorhexis. Ann Ophthalmol. 2001;33:13–20.

    Google Scholar 

  17. Khokhar S, Tejwani LK, Kumar G, Kushmesh R. Approach to cataract with persistent hyperplastic primary vitreous. J Cataract Refract Surg. 2011;37:1382–5.

    Article  Google Scholar 

  18. Palanker DV, Blumenkranz MS, Andersen D, et al. Femtosecond laser assisted cataract surgery with integrated optical coherence tomography. Sci Transl Med. 2010;2:58–85.

    Article  Google Scholar 

  19. Toropygin SG, Krause M, Akkaya A, et al. Experimental femtosecond laser-assisted nanosurgery of anterior lens capsule. Eur J Ophthalmol. 2011;21:237–42.

    Article  Google Scholar 

  20. Vasavada AR, Trivedi RH, Apple DJ, et al. Randomized, clinical trial of multiquadrant hydrodissection in pediatric cataract surgery. Am J Ophthalmol. 2003;135:84–8.

    Article  Google Scholar 

  21. Parks MM. Management of the posterior capsule in congenital cataracts. J Pediatr Ophthalmol Strabismus. 1984;21:114–7.

    CAS  PubMed  Google Scholar 

  22. BenEzra D, Cohen E. Posterior capsulectomy in pediatric cataract surgery the necessity of a choice. Ophthalmology. 1997;104:2168–74.

    Article  CAS  Google Scholar 

  23. Vasavada A, Desai J. Primary posterior capsulorhexis with and without anterior vitrectomy in congenital cataracts. J Cataract Refract Surg. 1997;23(Suppl 1):645–51.

    Article  Google Scholar 

  24. Alexandrakis G, Peterseim MM, Wilson ME. Clinical outcomes of pars plana capsulotomy with anterior vitrectomy in pediatric cataract surgery. J AAPOS. 2002;6:163–7.

    Article  Google Scholar 

  25. Guo S, Wagner RS, Caputo A. Management of the anterior and posterior lens capsules and vitreous in pediatric cataract surgery. J Pediatr Ophthalmol Strabismus. 2004;41:330–7.

    Article  Google Scholar 

  26. Lin AA, Buckley EG. Update on pediatric cataract surgery and intraocular lens implantation. Curr Opin Ophthalmol. 2010;21:55–9.

    Article  Google Scholar 

  27. Burk SE, Da Mata AP, Snyder ME, et al. Visualizing vitreous using Kenalog suspension. J Cataract Refract Surg. 2003;29:645–51.

    Article  Google Scholar 

  28. Khokhar S, Sharma R, Patil B, Sinha G, Nayak B, Kinkhabwala RA, et al. A safe technique for in-the-bag intraocular lens implantation in pediatric cataract surgery. Eur J Ophthalmol. 2015;25:57–9.

    Article  Google Scholar 

  29. Gimbel HV, DeBroff BM. Intraocular lens optic capture. J Cataract Refract Surg. 2004;30:200–6.

    Article  Google Scholar 

  30. Raina UK, Gupta V, Arora R, et al. Posterior continuous curvilinear capsulorhexis with and without optic capture of the posterior chamber intraocular lens in the absence of vitrectomy. J Pediatr Ophthalmol Strabismus. 2002;39:278–87.

    Article  Google Scholar 

  31. Zhou HW, Zhou F. A meta-analysis on the clinical efficacy and safety of optic capture in pediatric cataract surgery. Int J Ophthalmol. 2016;9:590–6.

    PubMed  PubMed Central  Google Scholar 

  32. Nihalani BR, Vanderveen DK. Secondary intraocular lens implantation after pediatric aphakia. J AAPOS. 2011;15:435–40.

    Article  Google Scholar 

  33. Kim DH, Kim JH, Kim SJ, et al. Long-term results of bilateral congenital cataract treated with early cataract surgery, aphakic glasses and secondary IOL implantation. Acta Ophthalmol. 2012;90:231–6.

    Article  Google Scholar 

  34. Wilson ME Jr, Hafez GA, Trivedi RH. Secondary in-the-bag intraocular lens implantation in children who have been aphakic since early infancy. J AAPOS. 2011;15:162–6.

    Article  Google Scholar 

  35. Grewal DS, Basti S. Modified technique for removal of Soemmering ring and in-the-bag secondary intraocular lens placement in aphakic eyes. J Cataract Refract Surg. 2012;38:739–42.

    Article  Google Scholar 

  36. Epley KD, Shainberg MJ, Lueder GT, et al. Pediatric secondary lens implantation in the absence of capsular support. J AAPOS. 2001;5:301–6.

    Article  CAS  Google Scholar 

  37. Dureau P, de Laage de Meux P, Edelson C, et al. Iris fixation of foldable intraocular lenses for ectopia lentis in children. J Cataract Refract Surg. 2006;32:1109–14.

    Article  Google Scholar 

  38. Bardorf CM, Epley KD, Lueder GT, et al. Pediatric transscleral sutured intraocular lenses: efficacy and safety in 43 eyes followed an average of 3 years. J AAPOS. 2004;8:318–24.

    Article  CAS  Google Scholar 

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Khokhar, S.K., Dhull, C., Gupta, Y. (2019). Surgical Management of Pediatric Cataract. In: Khokhar, S., Dhull, C. (eds) Atlas of Pediatric Cataract. Springer, Singapore. https://doi.org/10.1007/978-981-13-6939-1_14

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  • DOI: https://doi.org/10.1007/978-981-13-6939-1_14

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  • Publisher Name: Springer, Singapore

  • Print ISBN: 978-981-13-6938-4

  • Online ISBN: 978-981-13-6939-1

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