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Chapter-03 Congenital Cataract Surgery

BOOK TITLE: Surgical Techniques in Ophthalmology (Pediatric Ophthalmic Surgery)

Author
1. MC Ventura
2. LO Ventura
3. D Endriss
ISBN
9789350251485
DOI
10.5005/jp/books/11282_3
Edition
1/e
Publishing Year
2011
Pages
8
Author Affiliations
1. Altino Ventura Foundation and Pernambuco Eye Hospital, Pernambuco, Brazil
2. Altino Ventura Foundation and Pernambuco Eye Hospital, Pernambuco, Brazil
3. University Hospital, Antwerp, Belgium, Altino Ventura Foundation and Pernambuco Eye Hospital, Pernambuco, Brazil
Chapter keywords

Abstract

Congenital cataract is one of the leading causes of childhood blindness. Advances in surgical technique and optical rehabilitation specially seem to have significantly improved the prognosis for visual function in these children. Congenital cataract may be associated with posterior hyperplastic primary vitreous. Therapeutic approach must consider extension of lens opacity, age of the patient at onset, duration of visual deprivation, monocular versus binocular involvement and type of cataract. Careful examination of the cataract morphology, along with associated findings, is frequently helpful in determining the etiology and prognosis. Most authors advocate that surgery should be performed between the sixth and eight week of life for the best prognosis. Bilateral cases require surgery first in the eye with poorer vision, with surgery for the second eye within one week, except in cases of life risk, which both eyes should be operated on at the same day. A primary posterior capsulotomy combined with an anterior vitrectomy in all eyes of children under four years of age, via anterior approach is also recommended. The residual hyperopia is corrected by spectacles adjusted according the growth and refractional changes observed in the child. Early visual rehabilitation with proper refraction, spectacle prescription and antiamblyopia therapy are necessary to ensure optimal visual outcome after pediatric cataract surgery.

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