Cargando…

Updates on managements of pediatric cataract

PURPOSE: 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 intraocula...

Descripción completa

Detalles Bibliográficos
Autores principales: Mohammadpour, Mehrdad, Shaabani, Amirreza, Sahraian, Alireza, Momenaei, Bita, Tayebi, Fereshteh, Bayat, Reza, Mirshahi, Reza
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6611931/
https://www.ncbi.nlm.nih.gov/pubmed/31317088
http://dx.doi.org/10.1016/j.joco.2018.11.005
_version_ 1783432793501466624
author Mohammadpour, Mehrdad
Shaabani, Amirreza
Sahraian, Alireza
Momenaei, Bita
Tayebi, Fereshteh
Bayat, Reza
Mirshahi, Reza
author_facet Mohammadpour, Mehrdad
Shaabani, Amirreza
Sahraian, Alireza
Momenaei, Bita
Tayebi, Fereshteh
Bayat, Reza
Mirshahi, Reza
author_sort Mohammadpour, Mehrdad
collection PubMed
description PURPOSE: 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. METHODS: 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. RESULTS: 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. CONCLUSIONS: 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.
format Online
Article
Text
id pubmed-6611931
institution National Center for Biotechnology Information
language English
publishDate 2018
publisher Elsevier
record_format MEDLINE/PubMed
spelling pubmed-66119312019-07-17 Updates on managements of pediatric cataract Mohammadpour, Mehrdad Shaabani, Amirreza Sahraian, Alireza Momenaei, Bita Tayebi, Fereshteh Bayat, Reza Mirshahi, Reza J Curr Ophthalmol Article PURPOSE: 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. METHODS: 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. RESULTS: 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. CONCLUSIONS: 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. Elsevier 2018-12-22 /pmc/articles/PMC6611931/ /pubmed/31317088 http://dx.doi.org/10.1016/j.joco.2018.11.005 Text en © 2018 Iranian Society of Ophthalmology. Production and hosting by Elsevier B.V. http://creativecommons.org/licenses/by-nc-nd/4.0/ This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
spellingShingle Article
Mohammadpour, Mehrdad
Shaabani, Amirreza
Sahraian, Alireza
Momenaei, Bita
Tayebi, Fereshteh
Bayat, Reza
Mirshahi, Reza
Updates on managements of pediatric cataract
title Updates on managements of pediatric cataract
title_full Updates on managements of pediatric cataract
title_fullStr Updates on managements of pediatric cataract
title_full_unstemmed Updates on managements of pediatric cataract
title_short Updates on managements of pediatric cataract
title_sort updates on managements of pediatric cataract
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6611931/
https://www.ncbi.nlm.nih.gov/pubmed/31317088
http://dx.doi.org/10.1016/j.joco.2018.11.005
work_keys_str_mv AT mohammadpourmehrdad updatesonmanagementsofpediatriccataract
AT shaabaniamirreza updatesonmanagementsofpediatriccataract
AT sahraianalireza updatesonmanagementsofpediatriccataract
AT momenaeibita updatesonmanagementsofpediatriccataract
AT tayebifereshteh updatesonmanagementsofpediatriccataract
AT bayatreza updatesonmanagementsofpediatriccataract
AT mirshahireza updatesonmanagementsofpediatriccataract