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The management of posterior polar cataract: the role of patching and grading
1Ohkamp 28, Hamburg, Germany.
Insights
Even with late diagnosis, preschool children with milder posterior polar cataracts benefit from occlusion therapy and surgery. Early detection improves outcomes, but patching is recommended before surgical intervention.
Area of Science:
- Ophthalmology
- Pediatric ophthalmology
- Cataract surgery
Background:
- Milder posterior polar cataracts are often diagnosed late in preschool children, especially without strabismus.
- Delayed diagnosis can impact treatment effectiveness.
Purpose of the Study:
- To evaluate the efficacy of orthoptic and surgical treatment for preschool children with milder posterior polar cataracts.
- To determine if late-started treatment yields positive visual outcomes.
Main Methods:
- Retrospective study of 13 pediatric patients (median age 4 years) with posterior polar cataracts.
- Analysis of visual acuity before and after a mean follow-up of 4 years.
- Inclusion of occlusion therapy and surgical interventions.
Main Results:
- Significant visual acuity improvement observed, with median visual acuity increasing from 0.16 to 0.6.
- Surgery was initiated between two weeks and three years after starting occlusion therapy.
- All patients with milder cataracts showed benefits from treatment.
Conclusions:
- Late-initiated treatment for milder posterior polar cataracts can still be beneficial.
- Earlier detection of pediatric cataracts would further enhance prognosis.
- Ophthalmologists should consider patching therapy before opting for surgery.
Background:
The milder form of posterior polar cataract is often discovered late in preschool children if secondary symptoms like strabismus are not present. The question addressed in this paper is: do such children still profit from orthoptic and surgical treatment?
Patients And Methods:
This was a retrospective study of the data from 13 patients, median age 4 years (range: 1 month to 12 years), with a mean follow-up of 4 years. Four changes to the red reflex were introduced.
Results:
Surgery followed from two weeks to three years after starting occlusion therapy. Before therapy, the best visual acuity was 0.3 and the worst 0.06 (median 0.16). A median of four years after starting therapy, the visual acuity ranged from 0.9 to 0.4 (median 0.6).
Conclusion:
All milder cases profited from the treatment despite its late start. An earlier discovery would improve the prognosis. In any case, however, ophthalmologists should be encouraged to try patching before resorting to surgery.
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