Pediatric Cataract Surgery

Abstract

Pediatric cataracts are common and represent one of the most treatable causes of lifelong visual impairment in children. Management of childhood cataract is more challenging than cataract management in adults. Although cataract surgery in children has incorporated many innovations that started in adult surgery, unique features of children's eyes have required many modifications of the adult procedure. Challenges remain for surgery in the pediatric population, and these include anatomical differences, timing of surgery, how to avoid and/or treat amblyopia, how to prevent and treat visual axis opacification, and how to determine the optimum model and power of intraocular lens (IOL). In this chapter, we focus on surgical techniques and outcomes of cataract surgery in children. Presently, the treatment for a cataract is the surgical removal of the opaque lens. This is often followed by implantation of an IOL, either at the time of surgery or as a secondary procedure later in childhood. Primary IOL implantation during the first 6 months of life appears to increase the risk of reoperations, but primary IOL implantation is usually considered for children above 6 months of age. Postoperative complications occur more commonly after infantile than adult cataract surgery, and many of these complications do not develop until years later. As a result, it is critical that children be followed closely on a long-term basis after cataract surgery.