Cataract Surgery during Childhood and Youth
Böckmann M., Schaperdoth B., Bornfeld N., Steuhl K.-P., Hudde T.
University Eye Hospital, Essen
Purpose: Improved microsurgical techniques increased the safety of cataract surgery during childhood substantially. Often IOL implantation is possible (we implant at the age of 2 years or above). Patching, spectacles and/or contact lens wear helps visual acuity to develop.
Method: Retrospectively the charts of all patients under 18 years who underwent cataract surgery between 1997 and 2003 were reviewed. Intra and post operative courses including visual acuity and complications were examined.
Results: 48 patients (69 eyes) had cataract surgery at the age of in average 74 (0.5 to 191) months. In 42 eyes congenital cataract was present, in 6 eyes traumatic cataracts, and in 18 eyes cataract developed mainly because of syndromes. In 55 eyes an anterior surgical approach and in 14 eyes an approach via the pars plana was employed. An IOL was primarily implanted in 49 eyes. In most eyes a posterior capsulotomy was performed. In 18 eyes (mainly children with syndromes) no visual acuity could be obtained preoperatively and in 12 eyes postoperatively. Visual acuity improved in 37 eyes, was unchanged in 5 eyes and deteriorated one line in 5 eyes. In average vision improved by 1.8 (-1 to 10) lines.
Conclusions: Cataract surgery can be considered safe during childhood and youth. The essential complication is secondary glaucoma. Small incision surgery which spares the conjunctiva should be preferred in the view of potentially nec
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