Update on the surgical management of pediatric cataracts

The treatment of pediatric cataracts is rapidly evolving, and the visual prognosis for infants and children with cataracts is improving, due in part to earlier surgery, increased frequency of intraocular lens (IOL) implantation, more effective amblyopia therapy following surgery, and better forms of optical correction. A surgeon treating a child with a cataract is faced with An assortment of therapeutic dilemmas such as whether an IOL should be implanted, whether foldable lenses are appropriate, and whether the posterior capsule should be opened during surgery. Although the surgery can be technically difficult in small and unforgiving eyes, it is often the easy part as treatment decisions and results have lifelong implications. The visual system, which is immature at birth, has a latent period of approximately 6 weeks before it becomes sensitive to deprivation, and binocular vision first appears at approximately 3 months of age. It is therefore imperative that infants with visually significant congenital cataracts receive prompt treatment during the sensitive periods to decrease the risk of developing amblyopia or binocular abnormalities. An ideal time for early surgical intervention resulting in few complications and maximal visual outcome has not been identified with certainty. Perhaps the greatest overall change in the approach to the surgical treatment of pediatric cataracts has been the adaptation of techniques used in adult cataract surgery. This article focuses on the methods currently used in the management of pediatric cataracts.