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Is there a latent period for the surgical treatment of children with dense bilateral congenital cataracts?

Publication ,  Journal Article
Lambert, SR; Lynn, MJ; Reeves, R; Plager, DA; Buckley, EG; Wilson, ME
Published in: J AAPOS
February 2006

BACKGROUND: It generally is accepted that cataract surgery during the first 6 weeks of life is associated with the best visual outcomes for children with dense unilateral congenital cataracts. The latent period for children with dense bilateral congenital cataracts has not been clearly defined. METHODS: The best-corrected visual acuity (BCVA) at 4 to 6 years of age was collected retrospectively on a series of 43 children with dense bilateral congenital cataracts from 4 institutions. All of the children underwent a lensectomy, posterior capsulotomy, and anterior vitrectomy at 36 weeks of age or younger. RESULTS: Cataract surgery was performed at a mean age of 11.5 weeks for the better-seeing eye. BCVA was assessed when the children were a mean of 5.3 years of age. The visual acuities of 26 (60%) were 20/40 or better, 12 (28%) were 20/50 to 20/80, and 5 (12%) were 20/100 or worse. There was a trend for worse BCVA with increasing age at the time of surgery (r = 0.28, P = 0.07). We noted that a BCVA of 20/100 or worse occurred only among eyes undergoing surgery when infants were older than 10 weeks (10 weeks: 5/22 = 23%, P = 0.049). Children with preoperative nystagmus had worse visual outcomes; only 38% of children with preoperative nystagmus achieved a BCVA of 20/40 or better compared with 74% of children without preoperative nystagmus (P = 0.03). CONCLUSION: Previous reports have proposed that cataract surgery during the first 5 to 8 weeks of life is associated with better visual outcomes in children with dense bilateral congenital cataracts. Our results would suggest that good visual outcomes can be achieved beyond this age, but the incidence of poor visual outcomes increases if cataract surgery is delayed beyond 10 weeks of age. The absence of preoperative nystagmus is a better predictor of a good visual outcome than the age at surgery.

Duke Scholars

Published In

J AAPOS

DOI

ISSN

1091-8531

Publication Date

February 2006

Volume

10

Issue

1

Start / End Page

30 / 36

Location

United States

Related Subject Headings

  • Visual Acuity
  • Treatment Outcome
  • Time Factors
  • Retrospective Studies
  • Ophthalmology & Optometry
  • Male
  • Lens, Crystalline
  • Infant, Newborn
  • Infant
  • Humans
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Lambert, S. R., Lynn, M. J., Reeves, R., Plager, D. A., Buckley, E. G., & Wilson, M. E. (2006). Is there a latent period for the surgical treatment of children with dense bilateral congenital cataracts? J AAPOS, 10(1), 30–36. https://doi.org/10.1016/j.jaapos.2005.10.002
Lambert, Scott R., Michael J. Lynn, Rachel Reeves, David A. Plager, Edward G. Buckley, and M Edward Wilson. “Is there a latent period for the surgical treatment of children with dense bilateral congenital cataracts?J AAPOS 10, no. 1 (February 2006): 30–36. https://doi.org/10.1016/j.jaapos.2005.10.002.
Lambert SR, Lynn MJ, Reeves R, Plager DA, Buckley EG, Wilson ME. Is there a latent period for the surgical treatment of children with dense bilateral congenital cataracts? J AAPOS. 2006 Feb;10(1):30–6.
Lambert, Scott R., et al. “Is there a latent period for the surgical treatment of children with dense bilateral congenital cataracts?J AAPOS, vol. 10, no. 1, Feb. 2006, pp. 30–36. Pubmed, doi:10.1016/j.jaapos.2005.10.002.
Lambert SR, Lynn MJ, Reeves R, Plager DA, Buckley EG, Wilson ME. Is there a latent period for the surgical treatment of children with dense bilateral congenital cataracts? J AAPOS. 2006 Feb;10(1):30–36.
Journal cover image

Published In

J AAPOS

DOI

ISSN

1091-8531

Publication Date

February 2006

Volume

10

Issue

1

Start / End Page

30 / 36

Location

United States

Related Subject Headings

  • Visual Acuity
  • Treatment Outcome
  • Time Factors
  • Retrospective Studies
  • Ophthalmology & Optometry
  • Male
  • Lens, Crystalline
  • Infant, Newborn
  • Infant
  • Humans