Updates on managements of pediatric cataract

Area of Science:

• Ophthalmology
• Pediatric Surgery

Background:

• Congenital cataracts are a major cause of preventable childhood blindness.
• Effective management is crucial for visual development and preventing amblyopia.

Purpose of the Study:

• To provide a comprehensive review of congenital cataract management.
• To guide ophthalmologists on surgical techniques, postoperative care, and intraocular lens (IOL) controversies.

Main Methods:

• A systematic literature search was conducted in major databases (PubMed, Medline, Google Scholar, Web of Science).
• Keywords included "Congenital", "Pediatric", "Cataract", "Surgery", "Complication", and "Visual rehabilitation".
• 109 articles published between 1980 and 2017 were selected for review.

Main Results:

• Lens aspiration is indicated for significant lens opacity; surgery is recommended by 6-8 weeks of age.
• For children under six, lens aspiration with posterior capsulotomy and anterior vitrectomy is advised; IOL implantation may be considered for those over one year.
• Hydrophobic foldable acrylic posterior chamber intraocular lenses (PCIOLs) are preferred for reduced inflammation; age-based undercorrection is recommended.
• Timely detection and management of postoperative complications are vital for visual outcomes.
• Visual rehabilitation includes refractive correction, amblyopia treatment, and bifocal correction for school-aged children.

Conclusions:

• Congenital cataract management presents challenges due to visual development and ocular growth.
• Lifelong follow-up is essential for managing early and late postoperative complications.
• IOL implantation is not recommended for infants under one year; it is advised for children over two years with adequate capsular support.