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Chapter-05 Options in the Management of Pediatric Apharika

BOOK TITLE: Pediatric Cataract Surgery

Author
1. Ram Jagat
2. Brar Gagandeep Singh
ISBN
9788180619182
DOI
10.5005/jp/books/10596_5
Edition
1/e
Publishing Year
2007
Pages
14
Author Affiliations
1. Postgraduate Institute of Medical Education and Research, Chandigarh, India, Post Graduate Institute of Medical Education and Research, Chandigarh, India, Advanced Eye Centre, Postgraduate Institute of Medical Education and Research, Chandigarh, Advanced Eye Centre, Postgraduate Institute of Medical Education and Research, Chandigarh, India, Postgraduate Institute of Medical Education and Research Chandigarh, India, Advanced Eye Centre, Postgraduate Institute, of Medical Education and Research, Chandigarh, Post Graduate Institute of Medical Education and Research, Chandigarh, PGI, Chandigarh, India
2. Postgraduate Institute of Medical, Education and Research, Chandigarh, India, Postgraduate Institute of Medical Education and Research, Chandigarh, India, Grewal Eye Institute, Chandigarh, PGI, Chandigarh (India), PGI, Chandigarh, India, Advanced Eye Centre, Postgraduate Institute, of Medical Education and Research, Chandigarh
Chapter keywords

Abstract

The options in management of pediatric aphakia include aphakic glasses, contact lenses, and intraocular lens implantation. Aphakic glasses are considered to be safest method of aphakia correction. Ability to change power to compensate for the changing refractive status in growing pediatric eyes is an advantage. Problems with the use of aphakic glasses for rehabilitation of pediatric aphakia are optical problems associated with their use such as induced magnification, visual field restriction, and prismatic effect besides poor compliance. Aphakic glasses are a suitable mode of aphakic correction mostly in older children with bilateral aphakia who are intolerant to contact lenses. Contact lenses offer several advantages over aphakic spectacles, such as better visual field, less magnification, and better stereopsis. Extended wear contact lenses are used especially in very young children. However, major problems with the use of contact lenses in this age group remain the changing curvature of the cornea, repeated fittings under anesthesia, resistance of the child during repeated insertions and removals and intolerance to the lens. An intraocular lens provides fulltime correction and the optical component closely simulates the correcting capabilities of crystalline lens. Primary IOL gives instantaneous correction and superior visual rehabilitation and better compliance to amblyopia therapy. In children older than two years of age, primary intraocular lens implantation at the time of cataract surgery has become the standard of care. More and more surgeons are now using primary intraocular lens implantation even in children younger than two years of age provided the eye is not microphthalmic.

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