New trends in management of pediatric aphakia

Abstract

Good visual acuity (VA) and binocular vision in children with unilateral and bilateral cataracts may be attained, in much greater percentage of children following the removal of the congenital cataracts (Yamamoto et al., 1998). The best outcomes after surgery depend on many variables. This includes the extent of cataract, associated ocular or systemic abnormalities, early diagnosis and removal of cataract, optimum optical correction, and aggressive visual rehabilitation for treatment of amblyopia for several years (Parks, 1982). One should however remember that not every congenital cataract is amblyogenic. If the cataract is not complete and central, even nuclear cataract and increases gradually with the child’s age, prognosis for the improvement of vision is much better (Wright et al., 1992). In case of complete cataract, it is better to operate in the first weeks of child’s life, up to two months of age. Many clinicians choose the primary monocular lens implantation technique, which was routinely performed in the older children, over two years of age at least. However, it is still controversial surgery in newborns as it is associated with many complications (Lambert et al., 2003). Other solution is post-operative aphakia correction with contact lenses (Ma et al., 2003). Aphakic glasses are very rarely used in the correction of post-operative monocular or binocular aphakia in children due to their bad optics (Kim et al., 2012). Abnormal eye stimulation leads to the formation of abnormal visual retinal perception. It is associated with the development of amblyopia and nystagmus, and also frequently the concomitant strabismus (Cogate et al.,