Pediatric cataract and lens implantation

Cataracts in children present a greater management challenge, compared with cataracts in adults, because of the wider variety of causes and the vulnerability of the developing visual system. The fundamental principles--early diagnosis and treatment for visually significant cataracts--have not changed. Amblyopia remains a major problem in children with unilateral and asymmetrical cataracts. The use of vitrectomy instrumentation in the removal of infantile cataracts has become relatively standard; however, the tendency now is to leave a rim of posterior capsule sufficient to allow secondary placement of a posterior chamber intraocular lens at a later date. Intraocular lens implantation is being aggressively pursued in children and, with modern microsurgical techniques, may be desirable in children as young as 2 years of age or younger in special circumstances. Contact lenses continue to be ideal for the infant and growing child to provide flexibility as the refraction changes.