Predictive value of family data for the management of infantile bilateral partial cataract

To examine the data on outcome of surgery performed over a wide age range in members of a family affected by familial infantile bilateral partial cataract, with the purpose of assessing their predictive value concerning the timing of surgery.

A retrospective clinical study was carried out of a family with dominant inheritance of familial infantile bilateral partial cataract. The family spanned four generations and consisted of 53 members, 31 of whom were examined in our department. Of these, 18 were affected. Cataract surgery was performed in 26 eyes of 15 patients, whose ages ranged from 6 to 58 years at the time of operation. As the surgical procedures spanned the years from 1978 to 1996, different techniques were used.

In 24 eyes (92%) the post-operative visual acuity was 6/9 or better. One eye achieved 6/12 and another 6/15.

In this particular family there was no relationship between the post-operative visual acuity and the age at which surgery was performed. In deciding when to operate on family members with infantile bilateral partial cataract with similar morphology, in addition to the commonly used criteria the family data should also be taken into account. In infants and young children, delaying surgery may allow better development of visual acuity aided by accommodation, stabilisation of binocularity and more precise determination of the power of an intraocular lens. Success of very early surgery in such cases may not be attributable to the timing of the operation.