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Management of posterior lenticonus.
K P Cheng1, D A Hiles, A W Biglan
1Department of Ophthalmology, University of Pittsburgh School of Medicine, Pa.
Summary
Posterior lenticonus often causes progressive vision loss requiring cataract surgery. Postoperative outcomes highlight the persistent need for amblyopia treatment, even after lens removal and optical correction.
Area of Science:
- Ophthalmology
- Pediatric Ophthalmology
- Visual Optics
Background:
- Posterior lenticonus is a condition characterized by progressive lens opacification.
- It can lead to significant visual impairment in pediatric patients.
Purpose of the Study:
- To evaluate the surgical outcomes and long-term visual results in pediatric patients with posterior lenticonus.
- To assess the effectiveness of pre- and post-operative management strategies.
Main Methods:
- Retrospective case series of 40 patients (41 eyes) treated between 1974 and 1988.
- Pre-operative management included atropine, spectacle correction (bifocals), and amblyopia occlusion.
- Cataract surgery indications included decreased visual acuity, loss of fixation, or strabismus.
Main Results:
- Postoperative acuities varied: 49% achieved 20/20-20/40, 18% achieved 20/50-20/100, 10% achieved 20/200, and 10% worse than 20/200.
- Amblyopia persisted in 84% and strabismus in 51% post-surgery.
- Visual fixation reflexes were achieved in 5% and partially in 8% of patients.
Conclusions:
- Cataract surgery and optical correction alone are insufficient for optimal vision in posterior lenticonus.
- Aggressive amblyopia therapy, including occlusion, is crucial post-operatively.
- Earlier surgical intervention may be necessary to prevent severe visual deprivation amblyopia.