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Strabismus in Cases of Pediatric Cataract Before and After IOL-Implantation with Anterior Vitrectomy against Optic Capture - Two-Years-results from a Prospective, Randomized Study

1Rosenkranz C., 2Vanselow K., 1Lüchtenberg M., 3Kohnen T., 1Zubcov-Iwantscheff A. A.,
1Johann-Wolfgang-Goethe-Universität, Klinik für Augenheilkunde, Kinderaugenheikunde und Strabologie (Frankfurt/Main)
2 (Frankfurt/Main)
3Johann-Wolfgang-Goethe-Universität, Klinik für Augenheilkunde (Frankfurt/Main)

Purpose: The early diagnosis and treatment of the pediatric cataract is most importent for the development of visual acuity and stereopsis.
Patients and methods: We examined 20 eyes from 15 children divided into 3 groups to the age in the time of surgery (1,5-3; 3-6; 6-12 years). Afterwards we split the cases into two groups of different surgery technics in a randomised way. The surgery-technic A included a IOL-implantation with posterior capsulorrhexis and anterior vitrectomy. Technic B included a IOL implantation with posterior capsulorrhexis and optic capture without anterior vitrectomy. Two years after the surgery the observed stereopsis was compared with results before surgery.
Results: According to the binocularity in 14 cases a orthophoria (70%), in 6 cases a exotropia (30%) was observed before surgery, including 4 cases with bilateral cataract from the group 3 of patients between 6 and 12 years. After surgery in 3 children the exotropia was still resistent (microtropia divergens -2PD), 2 of these children had bilateral cataract (group 3) and one child had a unilateral cataract (group 2). The other 3 children became orthophoria (50%), whereby in 2 cases with unilateral cataract after the surgery a microtropia convergens (+2 PD- +5PD, 14%) was observed (group 1,2).
Conclusions: Our study shows that a pediatric cataract surgery can change the binocular function. In many cases a progressic of the stereopsis is resulted.

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