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Magnusson G, Gyllén J, Haargaard B, Nyström A, Rosensvärd A, Scurei C, Kjellström U, Tornqvist K. The prevalence of visual axis opacification in the Swedish Pediatric Cataract Register. Acta Ophthalmol 2024; 102:e873-e882. [PMID: 38251769 DOI: 10.1111/aos.16630] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2022] [Revised: 12/20/2023] [Accepted: 01/05/2024] [Indexed: 01/23/2024]
Abstract
PURPOSE To report on the occurrence of postoperative visual axis opacification (VAO) in children younger than 5 years of age operated for cataract in Sweden, and to analyse correlations with age at surgery and surgical method. METHODS Data were derived from the Swedish Pediatric Cataract Register (PECARE). All children operated on between 1 January 2007 and 31 December 2020 were included. Follow-ups at 1, 2 and 5 years of age were analysed. RESULTS Cataract surgery were performed on 770 eyes belonging to 549 children (n = 282 boys, 51.4%); 327/770 (42.5%) of the children underwent surgery before 3 months of age and 216/770 (28%) before 6 weeks of age. Data on 881 follow-up visits were registered. At the follow up-visits at 1, 2 and 5 years of age, VAO was present in 154/349 (44.1%), 41/323 (12.7%) and 25/208 (12%). The majority of the children with VAO underwent cataract surgery before age 6 months, with a predominance before age 2 months. Primary IOL was implanted in 601/770 (78%) of eyes; 40.8% had an acrylic one-piece lens, 31.8% had a bag-in-the-lens IOL, 21.9% were aphakic and 5.2% had an acrylic three-piece lens. Implantation of a bag-in-the-lens IOL was related to a significantly lower occurrence of VAO compared to other types of IOL, including aphakia (p < 0.0002). CONCLUSION Our results are in accordance with the literature. Primary bag-in-the-lens IOL implantation before 2 years of age seems adequate and safe, with a low occurrence of VAO, and can thus be continued as routine in Sweden.
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Affiliation(s)
- Gunilla Magnusson
- Region Västra Götaland, Department of Ophthalmology, Sahlgrenska University Hospital, Mölndal, Sweden
- Department of Clinical Neuroscience, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Jenny Gyllén
- Region Västra Götaland, Department of Ophthalmology, Sahlgrenska University Hospital, Mölndal, Sweden
- Department of Clinical Neuroscience, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | | | - Alf Nyström
- Region Västra Götaland, Department of Ophthalmology, Sahlgrenska University Hospital, Mölndal, Sweden
- Department of Clinical Neuroscience, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Annika Rosensvärd
- Division of Ophthalmology and Vision, Department of Clinical Neuroscience, Karolinska Institute, St Erik Eye Hospital, Stockholm, Sweden
| | - Carmen Scurei
- Division of Ophthalmology and Vision, Department of Clinical Neuroscience, Karolinska Institute, St Erik Eye Hospital, Stockholm, Sweden
| | - Ulrika Kjellström
- Department of Clinical Sciences, Ophthalmology, Skåne University Hospital, Lund University, Lund, Sweden
| | - Kristina Tornqvist
- Department of Clinical Sciences, Ophthalmology, Skåne University Hospital, Lund University, Lund, Sweden
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Yen KG, Repka MX, Sutherland DR, Haider KM, Hatt SR, Kraker RT, Galvin JA, Li Z, Cotter SA, Holmes JM. Complications Occurring Through 5 Years Following Primary Intraocular Lens Implantation for Pediatric Cataract. JAMA Ophthalmol 2023; 141:705-714. [PMID: 37347490 PMCID: PMC10288374 DOI: 10.1001/jamaophthalmol.2023.2335] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Accepted: 04/20/2023] [Indexed: 06/23/2023]
Abstract
Importance Lensectomy with primary intraocular lens (IOL) implantation is often used in the management of nontraumatic pediatric cataract, but long-term data evaluating the association of age and IOL location with the incidence of complications are limited. Objective To describe the incidence of complications and additional eye surgeries through 5 years following pediatric lensectomy with primary IOL implantation and association with age at surgery and IOL location. Design, Setting, and Participants This prospective cohort study used Pediatric Eye Disease Investigator Group cataract registry data from 61 institution- and community-based practices over 3 years (June 2012 to July 2015). Participants were children younger than 13 years without baseline glaucoma who had primary IOL implantation (345 bilateral and 264 unilateral) for nontraumatic cataract. Data analysis was performed between September 2021 and January 2023. Exposures Lensectomy with primary IOL implantation. Main Outcome and Measures Five-year cumulative incidence of complications by age at surgery (<2 years, 2 to <4 years, 4 to <7 years, and 7 to <13 years) and by IOL location (sulcus vs capsular bag) were estimated using Cox proportional hazards models. Results The cohort included 609 eyes from 491 children (mean [SD] age, 5.6 [3.3] years; 261 [53%] male and 230 [47%] female). Following cataract extraction with primary IOL implantation, a frequent complication was surgery for visual axis opacification (VAO) (cumulative incidence, 32%; 95% CI, 27%-36%). Cumulative incidence was lower with anterior vitrectomy at the time of IOL placement (12%; 95% CI, 8%-16%) vs without (58%; 95% CI, 50%-65%), and the risk of undergoing surgery for VAO was associated with not performing anterior vitrectomy (hazard ratio [HR], 6.19; 95% CI, 3.70-10.34; P < .001). After adjusting for anterior vitrectomy at lens surgery, there were no differences in incidence of surgery for VAO by age at surgery (<2 years, HR, 1.35 [95% CI, 0.63-2.87], 2 to <4 years, HR, 0.86 [95% CI, 0.44-1.68], 4 to <7 years, HR, 1.06 [95% CI, 0.72-1.56]; P = .74) or by capsular bag vs sulcus IOL fixation (HR, 1.22; 95% CI, 0.36-4.17; P = .75). Cumulative incidence of glaucoma plus glaucoma suspect by 5 years was 7% (95% CI, 4%-9%), which did not differ by age after controlling for IOL location and laterality. Conclusions and Relevance In this cohort study, a frequent complication following pediatric lensectomy with primary IOL was surgery for VAO, which was associated with primary anterior vitrectomy not being performed but was not associated with age at surgery or IOL location. The risk of glaucoma development across all ages at surgery suggests a need for long-term monitoring.
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Affiliation(s)
| | | | | | | | | | | | - Jennifer A. Galvin
- Eye Physicians & Surgeons, Milford, Connecticut
- Yale School of Medicine, New Haven, Connecticut
| | - Zhuokai Li
- Jaeb Center for Health Research, Tampa, Florida
| | - Susan A. Cotter
- Southern California College of Optometry at Marshall B. Ketchum University, Fullerton
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Wackerberg D, Nyström A, Haargaard B, Rosensvärd A, Tornqvist K, Borg L, Kugelberg M, Gyllén J, Magnusson G. Analysis of age at detection and outcomes of dense unilateral congenital cataract surgery for children on the paediatric cataract register. Acta Paediatr 2023; 112:277-285. [PMID: 36366873 PMCID: PMC10098656 DOI: 10.1111/apa.16591] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Revised: 11/07/2022] [Accepted: 11/08/2022] [Indexed: 11/13/2022]
Abstract
AIM Analysis of age at time of detection and surgery of dense unilateral cataract and investigation of best-corrected visual acuity (BCVA) in a nationwide register-based cohort study, based on the routine of maternity ward eye screening. METHODS Data were derived from the Paediatric Cataract Register (PECARE). All children (n = 54) diagnosed with dense congenital unilateral cataract between January 2007 and September 2014 who had surgery before 1 year of age, and for whom 5-year follow-up records were available, were included. RESULTS The majority, 35/54 (65%), were detected and operated on before age 6 weeks and 30/35 (86%) were referred from maternity wards. Visual acuity (VA) ≥ 0.5 (decimal, 0.3 logMAR) was found in 7/53 (13%) of the cohort at age 5 years; further, 19 children achieved VA ≥ 0.1 (decimal, 1.0 logMAR) (36%) and 19 children VA < 0.05 (decimal, 1.30 logMAR) (36%). Ten-year follow-up records were available for 17/53 (32%) children; 1/17 (6%) achieved VA ≥ 0.5 (decimal, 0.3 logMAR), 4/17 (24%) VA ≥ 0.3-<0.5 (decimal, 0.52-0.30 logMAR), 3/17 (18%) VA ≥ 0.05-0.1 (decimal, 1.30-1.0 logMAR) and 10/17 (59%) VA < 0.05 (decimal, 1.30 logMAR). CONCLUSION A total of 90% of the children were detected with cataract within 100 days of birth and 80% were operated on within this period. This study showed better visual acuity in those treated for dense unilateral cataracts than previously reported in an earlier Swedish cohort study.
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Affiliation(s)
- David Wackerberg
- Region Västra Götaland, Sahlgrenska University Hospital, Department of Ophthalmology, Mölndal, Sweden
| | - Alf Nyström
- Region Västra Götaland, Sahlgrenska University Hospital, Department of Ophthalmology, Mölndal, Sweden.,Department of Clinical Neuroscience, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Birgitte Haargaard
- Department of Opthalmology, Naestved Hospital, Naestved, Denmark.,Danish Serum Institute, Copenhagen, Denmark
| | - Annika Rosensvärd
- Division of Ophthalmology and Vision, Department of Clinical Neuroscience, Karolinska Institutet, St Erik Eye Hospital, Stockholm, Sweden
| | - Kristina Tornqvist
- Department of Clinical Sciences, Ophthalmology, Skane University Hospital, Lund University, Lund, Sweden
| | - Lovisa Borg
- Department of Medicine, Trelleborg Hospital, Trelleborg, Sweden
| | - Maria Kugelberg
- Division of Ophthalmology and Vision, Department of Clinical Neuroscience, Karolinska Institutet, St Erik Eye Hospital, Stockholm, Sweden
| | - Jenny Gyllén
- Region Västra Götaland, Sahlgrenska University Hospital, Department of Ophthalmology, Mölndal, Sweden.,Department of Clinical Neuroscience, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Gunilla Magnusson
- Region Västra Götaland, Sahlgrenska University Hospital, Department of Ophthalmology, Mölndal, Sweden.,Department of Clinical Neuroscience, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
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Systemic and ocular associations in pediatric patients undergoing cataract surgery. Graefes Arch Clin Exp Ophthalmol 2023; 261:241-246. [PMID: 35969326 DOI: 10.1007/s00417-022-05802-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2022] [Revised: 07/23/2022] [Accepted: 08/04/2022] [Indexed: 01/04/2023] Open
Abstract
PURPOSE Evaluation for systemic diagnosis is an important part of pediatric cataract management. While there are reports on associated systemic and ocular associations in children with infantile cataracts, reports specifying associations in large cohorts of children undergoing cataract surgery are lacking. METHODS Retrospective chart review of consecutive patients undergoing cataract surgery at a pediatric tertiary referral center during 30-year period was performed. Associated systemic and ocular associations were recorded. The etiologies were analyzed depending on laterality, age, and gender. RESULTS Seven-hundred twenty-seven patients (1135 eyes) were included for analysis: 408 (56%) with bilateral and 319 (44%) with unilateral cataract. An identifiable cause for cataract was identified in 66% (270/408) bilateral and 55% (176/319) unilateral cataract patients. Hereditary cataract accounted for 22% of bilateral cataracts. An underlying syndrome or genetic diagnosis was found in 24% bilateral (97/408, 86 genetic/syndromic, 11 metabolic) but only in 2% of unilateral cases (5/319). Cataracts were the result of treatment for cancer, or other systemic conditions requiring steroids, in 60/408 bilateral (15%) and 15/319 (5%) unilateral cataract patients. In contrast, unilateral cataracts had higher ocular associations (49%, 156/319) than bilateral cataracts (6%, 23/408) primarily ocular trauma (20%, 64/319) and persistent fetal vasculature (20%, 62/319). CONCLUSION Clinicians should be aware of potential systemic and ocular associations among children with visually significant cataracts. Those with no family history of juvenile cataract should be evaluated for systemic associations, and referral to genetics may be warranted in select cases.
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Kabylbekova A, Meirmanov S, Aringazina A, Orazbekov L, Auyezova A. Age at recognition and age at presentation for surgery for congenital and developmental cataract in Kazakhstan. Ann Med 2022; 54:1988-1993. [PMID: 35833752 PMCID: PMC9291700 DOI: 10.1080/07853890.2022.2091156] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
PURPOSE To investigate the age at recognition and presentation for surgery for congenital and developmental cataract at Kazakh Eye Research Institute in Kazakhstan. METHODS A retrospective review of children aged 0-18 years, who presented with congenital and developmental cataract between January 1, 2010 and December 31, 2020. All medical records were reviewed. Gender, age at recognition, age at surgery, laterality, residential location (rural/urban) were recorded. RESULTS The study population included 897 patients of children presented with congenital and developmental cataract over a 10-year study period, 58% of them were boys and 44.6% were from rural areas. Cataract was bilateral in 621 (69.2%) and unilateral in 276 (30.8%) of patients. Median age at recognition for patients with congenital/developmental cataract was 12 months. Median age at surgery for congenital/developmental cataract was 51 months. Only 14.7% of children underwent surgery within first year of life. The urban citizens underwent surgery earlier than patients from rural areas. The median delay in presentation for surgery was 15 months. CONCLUSION The average age at cataract surgery in the population of Kazakhstan is much older than in developed countries. It is essential to study barriers that associated with delayed presentation to build strategies to overcome them.Key messagesIt is known that cataract surgery in children early in life provides favourable visual outcome.Children with congenital and developmental cataract in Kazakhstan experience delay in surgical treatment.Children from rural areas undergo cataract surgery later than urban citizens.
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Affiliation(s)
- Aliya Kabylbekova
- Department of Population Health and Social Science, Kazakhstan's Medical University "KSPH", Almaty, Kazakhstan
| | - Serik Meirmanov
- College of Asia Pacific Studies, Ritsumeikan Asia Pacific University, Beppu City, Japan
| | - Altyn Aringazina
- Caspian International School of Medicine, Caspian University, Almaty, Kazakhstan
| | - Lukpan Orazbekov
- Department of Pediatric Ophthalmology, Kazakh Eye Research Institute, Almaty, Kazakhstan
| | - Ardak Auyezova
- Department of Population Health and Social Science, Kazakhstan's Medical University "KSPH", Almaty, Kazakhstan
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Kabylbekova A, Meirmanov S, Aringazina A, Orazbekov L, Auyezova A. Clinical characteristics of congenital and developmental cataract in Kazakhstan. Indian J Ophthalmol 2022; 70:4325-4330. [PMID: 36453339 PMCID: PMC9940559 DOI: 10.4103/ijo.ijo_939_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Purpose To study and describe clinical characteristics of congenital and developmental cataract at a tertiary eye care facility. Methods In this retrospective study, 942 children (1311 eyes) presenting with congenital/developmental cataract over a 10-year study period were included. Gender, age at surgery, main presenting complaint, morphologic type of cataract, laterality, family history, and associated findings were recorded. Results The overall proportion of boys and girls undergoing cataract surgery was approximately equal (P = 0.110). However, in the cases of bilateral cataract, the proportion of boys was larger than girls (P = 0.028). More than half (62.3%) of the patients underwent surgery at the age of >3 years. The main presenting complaint was white pupils, accounting for 48.1% of cases. Total cataract was the most common morphologic type in all age groups. In total, 133 children out of 942 (14.1%) had a positive family history of congenital/developmental cataract. Strabismus and nystagmus were seen in 27.2% and 19.3% of the eyes, respectively. Additional ocular dysmorphology was found in 97 (10.3%) of patients. Coexisting systemic disease was found in 149 (15.8%) cases. Among syndrome-associated cataracts, Down syndrome accounted for the majority of cases. Conclusion High prevalence of total cataracts as well as frequent association with strabismus and nystagmus are likely to be the consequences of delayed presentation.
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Affiliation(s)
- Aliya Kabylbekova
- Department of Population Health and Social Science, Kazakhstan’s Medical University, “KSPH”, Almaty, Kazakhstan,Correspondence to: Dr. Aliya Kabylbekova, Department of Population Health and Social Science, Kazakhstan’s Medical University “KSPH”, Almaty, Utepov St, 19 a, 050060, Kazakhstan. E-mail:
| | - Serik Meirmanov
- College of Asia Pacific Studies, Ritsumeikan Asia Pacific University, Beppu City, Japan
| | - Altyn Aringazina
- Office of Innovation Programs, Almaty Management University, Almaty, Kazakhstan
| | - Lukpan Orazbekov
- Department of Pediatric Ophthalmology, Kazakh Eye Research Institute, Almaty, Kazakhstan
| | - Ardak Auyezova
- Department of Population Health and Social Science, Kazakhstan’s Medical University, “KSPH”, Almaty, Kazakhstan
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Kooshki AM, Kooshki AM, Yaseri M, Nouri L, Alipour F. Experiences of Treatment With Contact Lenses in Aphakic Children With Unilateral Congenital Cataract: A Retrospective Study. Eye Contact Lens 2022; 48:222-227. [PMID: 35333798 DOI: 10.1097/icl.0000000000000885] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/02/2021] [Indexed: 11/25/2022]
Abstract
BACKGROUND AND OBJECTIVES Congenital cataract is a condition compromising the eye's crystalline lens in infants and is usually diagnosed at birth. It can lead to irreversible vision loss if not promptly detected and treated, especially in unilateral cases. Nowadays, children with congenital cataracts can undergo surgical removal of their opacified crystalline lenses, and visual rehabilitation is mandatory to prevent deep amblyopia. Contact lenses, predominantly of rigid gas-permeable (GP) type, are gaining more popularity for this matter. METHOD In this retrospective cohort study, unilateral aphakic children younger than 6 years referred to the Contact Lens Clinic at Farabi Eye Hospital from November 2011 to September 2019 were included. RESULTS Seventy-six unilateral aphakic children with congenital cataracts (57.9% boys and 42.1% girls) rehabilitated with GP were studied. The mean age of diagnosis and referral to the contact lens clinic were 20.0±19.8 and 32.0±24.4 weeks, respectively, while the mean follow-up time was 12.44±26.28 months. The mean visual acuity for children capable of cooperating at the last follow-up was 0.98±0.62 log MAR. Among the participants, eight children (9.7%) were diagnosed as glaucoma suspects. The mean initial base curve and power of GP lenses were 7.86±0.39 mm and 23.29±5.52 diopters, respectively. Only 21 parents (27.6%) reported nonadherence to the scheduled part-time patch program. CONCLUSION The results of this study showed GP-based optical treatment after early diagnosis, surgical removal of congenital cataracts, and a long-term close follow-up to be well tolerated by children and their parents, with acceptable parents' compliance and can thus be introduced as a safe and effective method to achieve desirable visual outcomes.
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Affiliation(s)
- Abdolreza M Kooshki
- Department of ophthalmology (A.M.K., A.M.K., L.N.), Eye Research Center, Farabi Eye Hospital Tehran University of Medical Sciences, Tehran, Iran; Department of Epidemiology and Biostatistics (M.Y.), School of Public Health, Tehran University of Medical Sciences, Tehran, Iran; Department of ophthalmology (F.A.), Eye Research Center, Farabi Eye, Tehran, Iran
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Sand MK, Cholidis S, Kristianslund O, Drolsum L. Primary intraocular lens implantation in infants with unilateral congenital cataract operated before 12 weeks of age. Acta Ophthalmol 2022; 100:526-533. [PMID: 35411695 DOI: 10.1111/aos.15155] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2021] [Revised: 03/29/2022] [Accepted: 03/30/2022] [Indexed: 11/30/2022]
Abstract
PURPOSE The aim of this study was to report visual outcome and safety after cataract surgery with primary intraocular lens implantation before 12 weeks of age. METHODS Infants with visually significant unilateral congenital cataract having primary IOL implantation in the capsular bag before 12 weeks of age in 2007-2016 were enrolled for a prospective study examination in 2017. The medical records were also reviewed. RESULTS In total, 23 patients with a median age at cataract surgery of 32 days (range, 12-75 days) were included. Seventeen (74%) eyes had persistent foetal vasculature (PFV). After a median follow-up of 6.3 years (range, 1.4-10.9 years), the corrected distance visual acuity was 0.8 logMAR (range, 3.0-0.1 logMAR). All, except one eye, required surgery for visual axis opacification (VAO), with a median of two (range 0-5) additional surgical procedures. Four (17%) eyes developed secondary glaucoma. CONCLUSION Cataract surgery with primary IOL implantation before 12 weeks of age resulted in a high number of VAO operations, and the visual outcome varied considerably, showing the range in outcome for this challenging patient group. Co-existent PFV in these young patients was common. The incidence of secondary glaucoma was similar to other studies, despite the young age at surgery, high percentage of PFV and number of surgical procedures for VAO.
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Affiliation(s)
- Mari Kathrine Sand
- Department of Ophthalmology Oslo University Hospital Oslo Norway
- Institute of Clinical Medicine University of Oslo Oslo Norway
| | - Symira Cholidis
- Department of Ophthalmology Oslo University Hospital Oslo Norway
| | - Olav Kristianslund
- Department of Ophthalmology Oslo University Hospital Oslo Norway
- Institute of Clinical Medicine University of Oslo Oslo Norway
| | - Liv Drolsum
- Department of Ophthalmology Oslo University Hospital Oslo Norway
- Institute of Clinical Medicine University of Oslo Oslo Norway
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Lenhart PD, Lambert SR. Current management of infantile cataracts. Surv Ophthalmol 2022; 67:1476-1505. [DOI: 10.1016/j.survophthal.2022.03.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Revised: 03/13/2022] [Accepted: 03/14/2022] [Indexed: 10/18/2022]
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Huang LC, Kumar P, Fredrick DR, Alcorn DM, Koo EB, Stell L, Lambert SR. Referral patterns for infantile cataracts in two regions of the United States. J AAPOS 2022; 26:6.e1-6.e5. [PMID: 34973446 PMCID: PMC8976719 DOI: 10.1016/j.jaapos.2021.09.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2021] [Revised: 08/22/2021] [Accepted: 09/05/2021] [Indexed: 02/03/2023]
Abstract
BACKGROUND Delayed treatment of congenital or infantile cataracts can cause deprivation amblyopia. Prompt diagnosis and surgical intervention is critical for optimal outcomes. This study assessed referral patterns for congenital or infantile cataracts in two regions of the United States. METHODS The medical records of children 0-1 years of age with congenital or infantile cataracts at Stanford University (2008-2018) and Emory University (2010-2015) were reviewed retrospectively. RESULTS A total of 111 children were included. Of these, 82 (74%) were initially evaluated by a primary care doctor, of whom 40 (49%) were referred directly to a pediatric cataract surgeon. Of 61 newborns 0-2 months of age, 9 (15%) were initially referred to an eye care provider before 6 weeks of age, but the initial evaluation by a pediatric cataract surgeon was delayed until after 6 weeks of age. Referral patterns were similar between the two institutions (P = 0.06). CONCLUSIONS Many children with congenital of infantile cataracts are initially referred by a primary care doctor to an eye care provider who does not perform pediatric cataract surgery. Nevertheless, the majority of newborn infants with cataracts were evaluated by a pediatric cataract surgeon before 6 weeks of age.
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Affiliation(s)
- Laura C Huang
- Department of Ophthalmology, University of Washington, Seattle, Washington; Division of Pediatric Ophthalmology, Seattle Children's Hospital, Seattle, Washington
| | - Priyanka Kumar
- Department of Ophthalmology, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - Douglas R Fredrick
- Casey Eye Institute, Department of Ophthalmology, Oregon Health Science University, Portland, Oregon
| | - Deborah M Alcorn
- Byers Eye Institute, Department of Ophthalmology, Stanford University, Palo Alto, California; Stanford Children's Health, Palo Alto, California
| | - Euna B Koo
- Byers Eye Institute, Department of Ophthalmology, Stanford University, Palo Alto, California; Stanford Children's Health, Palo Alto, California
| | - Laurel Stell
- Department of Biomedical Data Science, Stanford University, Palo Alto, California
| | - Scott R Lambert
- Byers Eye Institute, Department of Ophthalmology, Stanford University, Palo Alto, California; Stanford Children's Health, Palo Alto, California.
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Sillen H, Van Looveren J, Plaeke P, Van Os L, Tassignon MJ. Real-time intraoperative OCT imaging of the vitreolenticular interface during pediatric cataract surgery. J Cataract Refract Surg 2021; 47:1153-1160. [PMID: 34468452 DOI: 10.1097/j.jcrs.0000000000000609] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2020] [Accepted: 01/27/2021] [Indexed: 11/26/2022]
Abstract
PURPOSE To report on the use of intraoperative optical coherence tomography (OCT) imaging of the vitreolenticular interface (VLI) during pediatric cataract surgery and to determine the incidence of VLI dysgenesis and surgical difficulties. SETTING Department of Ophthalmology, Antwerp University Hospital, Edegem, Belgium. DESIGN Retrospective cohort study. METHODS This study included 51 pediatric patients who underwent cataract surgery between April 2016 and December 2018. Video recordings and OCT images of the VLI were analyzed and compared. VLI dysgenesis was considered present when intraoperative OCT images demonstrated partial or total adhesions between the posterior lens capsule and the anterior hyaloid membrane. Video recordings were analyzed to describe surgical difficulties, more specifically: inability to create a calibrated primary posterior continuous curvilinear capsulorhexis (PPCCC), occurrence of vitreous prolapse, need for anterior vitrectomy, and complicated IOL implantation. RESULTS Of the 51 patients included, VLI dysgenesis was demonstrated in 27 patients (52.9%). The incidence of VLI dysgenesis was greater in children with unilateral cataract (72.4%), and children with a posterior capsule plaque (90%). PPCCC was challenging in 20 patients. A defect of the anterior hyaloid membrane was found in 16 patients. Anterior vitrectomy or cutting vitreous strands with scissors was necessary in 10 patients. CONCLUSIONS Intraoperative OCT images were an excellent tool to evaluate the VLI and to demonstrate the presence of VLI dysgenesis during pediatric cataract surgery. Performing a calibrated PPCCC was more challenging in the presence of VLI dysgenesis. This can subsequently expose a defect in the anterior hyaloid membrane, which may result in vitreous prolapse.
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Affiliation(s)
- Hedwig Sillen
- From the Department of Ophthalmology, Antwerp University Hospital, Belgium (Sillen, Van Os, Tassignon); Faculty of Medicine and Health Sciences, University of Antwerp, Belgium (Sillen, Van Looveren, Plaeke, Van Os, Tassignon); Department of Ophthalmology, AZ Klina, Brasschaat, Belgium (Van Looveren); Laboratory of Experimental Medicine and Pediatrics, University of Antwerp, Belgium (Plaeke); Department of Ophthalmology, University of Antwerp, Belgium (Van Os, Tassignon)
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Self JE, Taylor R, Solebo AL, Biswas S, Parulekar M, Dev Borman A, Ashworth J, McClenaghan R, Abbott J, O'Flynn E, Hildebrand D, Lloyd IC. Cataract management in children: a review of the literature and current practice across five large UK centres. Eye (Lond) 2020; 34:2197-2218. [PMID: 32778738 PMCID: PMC7784951 DOI: 10.1038/s41433-020-1115-6] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2020] [Revised: 07/02/2020] [Accepted: 07/16/2020] [Indexed: 01/21/2023] Open
Abstract
Congenital and childhood cataracts are uncommon but regularly seen in the clinics of most paediatric ophthalmology teams in the UK. They are often associated with profound visual loss and a large proportion have a genetic aetiology, some with significant extra-ocular comorbidities. Optimal diagnosis and treatment typically require close collaboration within multidisciplinary teams. Surgery remains the mainstay of treatment. A variety of surgical techniques, timings of intervention and options for optical correction have been advocated making management seem complex for those seeing affected children infrequently. This paper summarises the proceedings of two recent RCOphth paediatric cataract study days, provides a literature review and describes the current UK 'state of play' in the management of paediatric cataracts.
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Affiliation(s)
- J E Self
- Department of Ophthalmology, University Hospital Southampton, Southampton, UK.
- Clinical and Experimental Sciences, School of Medicine, University of Southampton, Southampton, UK.
| | - R Taylor
- Department of Medical Genetics, St Mary's Hospital, Manchester, UK
| | - A L Solebo
- Great Ormond Street Hospital, London, UK
| | - S Biswas
- Manchester Royal Eye Hospital, Manchester, UK
| | - M Parulekar
- Birmingham Children's Hospital, Birmingham, UK
| | | | - J Ashworth
- Manchester Royal Eye Hospital, Manchester, UK
| | - R McClenaghan
- Department of Ophthalmology, University Hospital Southampton, Southampton, UK
| | - J Abbott
- Birmingham Children's Hospital, Birmingham, UK
| | - E O'Flynn
- Department of Ophthalmology, University Hospital Southampton, Southampton, UK
| | | | - I C Lloyd
- Great Ormond Street Hospital, London, UK
- Manchester Royal Eye Hospital, Manchester, UK
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Nyström A, Haargaard B, Rosensvärd A, Tornqvist K, Magnusson G. The Swedish National Pediatric Cataract Register (PECARE): incidence and onset of postoperative glaucoma. Acta Ophthalmol 2020; 98:654-661. [PMID: 32274899 DOI: 10.1111/aos.14414] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2019] [Revised: 02/28/2020] [Accepted: 03/01/2020] [Indexed: 12/25/2022]
Abstract
PURPOSE The aim was to report cumulative incidence and time of onset of postoperative glaucoma in a paediatric early cataract surgery cohort. METHODS Data were retrieved from the Pediatric Cataract Register (PECARE), a prospective register of Swedish cataract operations before 8 years of age. All eyes with surgery between January 2007 and December 2014 and a registered follow-up were included. Cataracts caused by uveitis, trauma or coexisting congenital glaucoma were excluded. Glaucoma was defined as early onset if diagnosed within a year after surgery and late onset if diagnosed later. RESULTS The study included 288 eyes in 207 children (106 girls), 81 with bilateral and 126 with unilateral cataracts, with a mean follow-up of 3.31 ± 1.77 years. Of the 288, 168 (58.3%) had surgery before 3 months of age; most of these 92.3% (155/168) were defined as dense, 208 (72.2%) were below 1 year of age. Cumulative incidence of surgically treated glaucoma among individuals was 23.7% (49/207). Median time to glaucoma onset was 0.91 years (range: 0.05-4.97 years) for eyes. Early-onset glaucoma was found in 98 % (63/64), and late onset in 2% (1/64). CONCLUSION In this paediatric cataract cohort, a majority of eyes had surgery before 3 months of age (58.3%). Secondary glaucoma-onset peaked within the first postoperative year, with a cumulative incidence of 23.7%. Surgery performed after the first month of life, resulted in a lower glaucoma rate. Long-term follow-up will reveal whether the low rate of late-onset glaucoma with early surgery will last, and if so, the consequences.
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Affiliation(s)
- Alf Nyström
- Department of Ophthalmology Region Västra Götaland Sahlgrenska University Hospital Mölndal Sweden
- Department of Clinical Neuroscience Institute of Neuroscience and Physiology The Sahlgrenska Academy University of Gothenburg Gothenburg Sweden
| | | | - Annika Rosensvärd
- Division of Ophthalmology and Vision Department of Clinical Neuroscience Karolinska Institute St Erik Eye Hospital Stockholm Sweden
| | - Kristina Tornqvist
- Department of Clinical Sciences Ophthalmology Lund University Lund Sweden
| | - Gunilla Magnusson
- Department of Ophthalmology Region Västra Götaland Sahlgrenska University Hospital Mölndal Sweden
- Department of Clinical Neuroscience Institute of Neuroscience and Physiology The Sahlgrenska Academy University of Gothenburg Gothenburg Sweden
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A contiguous microdeletion syndrome at Xp23.13 with non-obstructive azoospermia and congenital cataracts. J Assist Reprod Genet 2020; 37:471-475. [PMID: 31916079 DOI: 10.1007/s10815-019-01685-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2019] [Accepted: 12/27/2019] [Indexed: 12/30/2022] Open
Abstract
Non-obstructive azoospermia accounts for 10-15% of male infertility, resulting in 60% of all cases of azoospermia and affecting about 1% of the male population. About 30% of these cases are due to Y chromosome microdeletions, chromosome abnormalities, or hormonal disorders. Pathogenic variants in genes on the sex chromosomes have key roles in spermatogenic failure. The co-occurrence of azoospermia and congenital cataracts ranges between 1 in 165,000 and 1 in 500,000. Our 28-year-old patient with normal intelligence and abnormally shaped teeth presented with both disorders. A microarray revealed a microdeletion at Xp23.13 with a whole NHS gene deletion as well as a contiguous deletion of two other genes [SCML1 and RAI2]. This observation represents the first report of non-obstructive azoospermia with congenital cataracts and a contiguous deletion of the SCML1 gene, a transcript of which is exclusively expressed in the testis. SCML1 is the putative culprit gene, which requires functional study or animal experiments. Our analysis of 60 known spermatogenesis failure-related genes by whole-exome sequencing revealed no other candidate. The Nance-Horan syndrome due to pathogenic variants in the NHS gene at Xp23.13 including whole gene deletion does not have azoospermia as a feature. Our report adds to the completeness of genetic counseling for an individual with azoospermia and congenital cataracts.
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Volkmann M, Richter R, Herrmann T, Hentze S, Hör M, Hasche H, Selle B, Stremmel W, Gehrke SG. Hereditary hyperferritinaemia-cataract syndrome (HHCS) – an underestimated condition: ferritin light chain variant spectrum in German families. Clin Chem Lab Med 2019; 57:1837-1845. [DOI: 10.1515/cclm-2018-1354] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2018] [Accepted: 05/19/2019] [Indexed: 01/08/2023]
Abstract
Abstract
Background
In hereditary hyperferritinaemia-cataract syndrome (HHCS), single nucleic acid alterations in the ferritin light chain (L-ferritin) iron response element (IRE) constitutively derepress ferritin synthesis, resulting in hyperferritinaemia, L-ferritin deposits in the lens of the eye and early bilateral cataract onset.
Methods
In this study, six German families with putative HHCS were analysed. Clinical diagnosis of HHCS was based on medical history, evaluation of ferritin serum levels, transferrin saturation and clinical ophthalmological examination. Diagnosis was confirmed by polymerase chain reaction (PCR)-based DNA sequencing of the L-ferritin IRE.
Results
Genetic analysis of the L-ferritin IRE revealed relevant single nucleic acid alterations in each of the affected families. Variants c.-168G > A, c.-168G > U and c.-167C > U were located in the C-bulge region; and variants c.-161C > U and c.-157G > A were located in the hexanucleotide loop of the L-ferritin IRE.
Conclusions
Family history of hyperferritinaemia and juvenile cataracts are strong indicators of HHCS. Genetic analysis of the L-ferritin IRE is a straightforward procedure to confirm the diagnosis. Accurate diagnosis of hyperferritinaemia can avoid unnecessary treatment by venesection, and focus attention on early cataract detection in offspring at risk.
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Affiliation(s)
| | - Rudolf Richter
- MVZ Labor PD Dr. Volkmann & Kollegen , Karlsruhe , Germany
| | - Thomas Herrmann
- Medizinische Klinik 1 , Westküstenklinikum Heide , Heide , Germany
| | | | - Michaela Hör
- Städtisches Klinikum Karlsruhe gGmbH, Augenklinik , Karlsruhe , Germany
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Mataftsi A, Haidich AB, Ziakas N. Intraocular lens implantation in children with cataract. THE LANCET CHILD & ADOLESCENT HEALTH 2019; 3:e5. [DOI: 10.1016/s2352-4642(19)30150-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/04/2019] [Accepted: 04/12/2019] [Indexed: 11/29/2022]
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Risk of aphakic glaucoma after pars plana-lensectomy with and without removal of the peripheral lens capsule. Eye (Lond) 2019; 33:1472-1477. [PMID: 30971816 DOI: 10.1038/s41433-019-0435-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2018] [Revised: 11/30/2018] [Accepted: 12/05/2018] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND The etiology of aphakic glaucoma is unclear. It has been suggested that remaining lens epithelium releases cytokines transducing trabecular meshwork cells. Therefore, we compared two cohorts of children undergoing lensectomy. In cohort 1, the entire lens including its capsule was removed, in cohort 2 the peripheral lens capsule was left intact, also to facilitate secondary intraocular lens implantation later on. METHODS We included children with uni- or bilateral congenital cataract who underwent lensectomy during the first year of life with subsequent contact lenses fitting. Group 1 comprised 41 eyes, group 2 comprised 33 eyes. In group 1, the median age at surgery was 4.0 months in unilateral and 3.0 months in bilateral cases 1, in group 2, 8.1 months and 2.4 months, respectively. The mean follow-up was 12.8 years in group 1 and 9.3 years in group 2. All cases were analyzed for the prevalence of aphakic glaucoma, for visual acuity and for compliance in visual rehabilitation (contact lens/occlusion therapy). RESULTS We found no significant difference in glaucoma prevalence between group 1 and group 2 (p = 0.68). The overall glaucoma rate was 26% after the mean follow-up of 11 years in both groups. In unilateral cases, the median visual acuity was logMAR 0.7 in both groups. In bilateral cases it was logMAR 0.4 in group 1 and logMAR 0.2 in group 2 (p = 0.05). CONCLUSIONS Leaving the peripheral lens capsule intact had no negative effect on the incidence of glaucoma and on resulting visual acuity.
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Van Looveren J, Van Gerwen V, Schildermans K, Laukens K, Baggerman G, Tassignon MJ. Proteomic analysis of posterior capsular plaques in congenital unilateral cataract. Acta Ophthalmol 2018; 96:e963-e969. [PMID: 30280517 DOI: 10.1111/aos.13782] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2017] [Accepted: 03/12/2018] [Indexed: 12/31/2022]
Abstract
PURPOSE To obtain insights on the protein composition of posterior capsular plaques (PCP) in congenital unilateral cataract with anterior vitreolenticular interface dysgenesis (AVLID). METHODS Posterior capsular plaque's were collected during surgery in children presenting with congenital unilateral cataract. Surgeries were analysed focusing on the type of cataract, the integrity of the posterior capsule after peeling the PCP and the presence of vitreolenticular adherences when performing primary posterior capsulorhexis. Proteome analysis was performed on the collected PCPs. RESULTS Posterior capsular plaques collection and proteome analysis were feasible from four children presenting with unilateral idiopathic congenital cataract and AVLID. A large portion of the proteins found in the PCPs was similar to the proteins known to be present in lens epithelial cells and fibres. Proteins like vimentin, fibronectin, collagen type I, collagen type VI and lumican were also found, which typically are present in mesenchymal tissue but not in lens tissue or capsule. CONCLUSION Posterior capsular plaques in cases of unilateral idiopathic congenital cataract of the AVLID type present a protein composition of mainly proteins found in lens epithelial cells and fibres. Some proteins however are a specific for lens tissue and are typically seen in mesenchymal tissue.
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Affiliation(s)
- Jan Van Looveren
- Department of Ophthalmology; Antwerp University Hospital; Edegem Belgium
- Faculty of Medicine and Health Sciences; University of Antwerp; Antwerp Belgium
| | - Veerle Van Gerwen
- Faculty of Medicine and Health Sciences; University of Antwerp; Antwerp Belgium
| | | | - Kris Laukens
- Department of Mathematics and Computer Science; University of Antwerp; Antwerp Belgium
| | - Geert Baggerman
- Centre for Proteomics; University of Antwerp; Wilrijk Belgium
| | - Marie-José Tassignon
- Department of Ophthalmology; Antwerp University Hospital; Edegem Belgium
- Faculty of Medicine and Health Sciences; University of Antwerp; Antwerp Belgium
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Solebo AL, Cumberland P, Rahi JS. 5-year outcomes after primary intraocular lens implantation in children aged 2 years or younger with congenital or infantile cataract: findings from the IoLunder2 prospective inception cohort study. THE LANCET CHILD & ADOLESCENT HEALTH 2018; 2:863-871. [PMID: 30389448 DOI: 10.1016/s2352-4642(18)30317-1] [Citation(s) in RCA: 72] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/25/2018] [Revised: 09/28/2018] [Accepted: 09/28/2018] [Indexed: 02/06/2023]
Abstract
BACKGROUND International initiatives to prevent childhood blindness have highlighted the importance of early, effective intervention for congenital and infantile cataract. In the UK, intraocular lens implantation has been widely adopted by surgeons to treat these conditions. However, evidence about the benefits and risks of this technique in different age groups is limited. The IoLunder2 study assessed outcomes following primary intraocular lens implantation in children aged 2 years and younger with congenital or infantile cataract. METHODS The IoLunder2 study was a prospective observational cohort study done at 31 sites in the UK and Ireland. Eligible children were aged 2 years or younger who had cataract surgery concurrently with intraocular lens implantation or conventional treatment (aphakic correction with contact lenses or glasses) after cataract surgery between Jan 1, 2009, and Dec 31, 2010. Children with significant ocular comorbidity precluding lens implantation, defined by the presence of complex persistent fetal vasculature, other ocular structural anomalies, severe microcornea (horizontal corneal diameter <9·5 mm), or severe microphthalmos (axial length <16 mm), were excluded from the analysis of the key outcomes. Postoperative visual rehabilitation was assessed at 1, 3, and 5 years after surgery with a 4m logarithm of the minimum angle of resolution (logMAR) notation test. Best corrected visual outcome (acuity) overall was assessed 5 years after surgery for children with bilateral and unilateral cataract. We also used multivariable logistic and linear regression to model the association between intraocular lens implantation and outcomes of interest (vision, glaucoma, and visual axis opacity). FINDINGS A total of 256 eligible children were recruited; two had incomplete data and were excluded. 158 of the 254 included children (102 [65%] with bilateral cataract and 56 [35%] with unilateral cataract) had no significant ocular morbidity and were analysed for the key outcomes. Primary intraocular lens implantation was done in 88 (56%) of 158 children (50 children with bilateral cataract and 38 children with unilateral cataract). 70 (44%) of 158 children had conventional treatment (52 with bilateral cataract and 18 with unilateral cataract). Overall median visual acuity at 5 years was 0·34 logMAR (IQR 0·20-0·54) for children with bilateral cataract and 0·70 logMAR (IQR 0·3-1·3) in the operated eye for children with unilateral cataract. Primary intraocular lens implantation was not associated with better visual outcome than conventional treatment in children with bilateral cataract (adjusted coefficient -0·1, 95% CI -0·5 to 0·3, p=0·48) or unilateral cataract (adjusted coefficient -0·3, -0·6 to 0·2, p=0·36), or reduced incidence of postoperative glaucoma in children with bilateral cataract (adjusted odds ratio [OR] 0·5, 0·10 to 1·80, p=0·28), but was associated with a five times higher risk of reoperation for visual axis opacity requiring general anaesthesia in children with bilateral cataract (adjusted OR 5·94, 95% CI 2·14-16·47, p=0·001) and a 20 times higher risk in children with unilateral cataract (20·15, 3·01-134·00, p=0·001). INTERPRETATION The findings of this cohort study indicate that intraocular lens implantation does not confer better vision or protection against postoperative glaucoma, and conversely increases the risk of requiring early reoperation in children younger than 2 years with bilateral or unilateral cataract. The routine use of intraocular lens implantation in this age group cannot be recommended. FUNDING National Institute for Health Research, Ulverscroft Foundation, and the Academy of Medical Sciences.
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Affiliation(s)
- Ameenat Lola Solebo
- Life Course Epidemiology and Biostatistics Section, UCL Great Ormond Street Institute of Child Health, University College London, London, UK; UCL Institute of Ophthalmology, University College London, London, UK; Great Ormond Street Hospital NHS Foundation Trust, London, UK; NIHR Moorfields Eye Hospital Biomedical Research Centre, London, UK; Moorfields Eye Hospital NHS Foundation Trust, London, UK
| | - Phillippa Cumberland
- Life Course Epidemiology and Biostatistics Section, UCL Great Ormond Street Institute of Child Health, University College London, London, UK; NIHR Great Ormond Street Hospital Biomedical Research Centre, London, UK
| | - Jugnoo S Rahi
- Life Course Epidemiology and Biostatistics Section, UCL Great Ormond Street Institute of Child Health, University College London, London, UK; UCL Institute of Ophthalmology, University College London, London, UK; Great Ormond Street Hospital NHS Foundation Trust, London, UK; NIHR Moorfields Eye Hospital Biomedical Research Centre, London, UK; Moorfields Eye Hospital NHS Foundation Trust, London, UK; NIHR Great Ormond Street Hospital Biomedical Research Centre, London, UK.
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Xie YB, Ren MY, Wang Q, Wang LH. Intraocular lens optic capture in pediatric cataract surgery. Int J Ophthalmol 2018; 11:1403-1410. [PMID: 30140648 DOI: 10.18240/ijo.2018.08.24] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2018] [Accepted: 06/27/2018] [Indexed: 12/28/2022] Open
Abstract
Posterior capsule opacification (PCO) remains the most common complication of pediatric cataract surgery despite continuous efforts to reduce its incidence. For this reason, pediatric cataract surgeons have expended considerable effort into preventing and mitigating PCO. The intraocular lens (IOL) optic capture technique has been used for the prevention of PCO after pediatric cataract surgery for more than 20y, but there is still no professional consensus. However, recent research has shown encouraging results. The IOL optic capture technique can be performed without anterior vitrectomy to prevent PCO, even in younger children. The type and characteristics of IOLs used for optic capture technique, the location of IOL and the complications of IOL optic capture in children are here reviewed.
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Affiliation(s)
- Ying-Bin Xie
- Department of Ophthalmology, Shandong Provincial Hospital Affiliated to Shandong University, Jinan 250021, Shandong Province, China
| | - Mei-Yu Ren
- Department of Ophthalmology, Shandong Provincial Hospital Affiliated to Shandong University, Jinan 250021, Shandong Province, China
| | - Qi Wang
- Department of Ophthalmology, Shandong Provincial Hospital Affiliated to Shandong University, Jinan 250021, Shandong Province, China
| | - Li-Hua Wang
- Department of Ophthalmology, Shandong Provincial Hospital Affiliated to Shandong University, Jinan 250021, Shandong Province, China
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