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Abstract #99146 Published in IGR 22-4
Current management of infantile cataracts
Lenhart PD; Lambert SRSurvey of Ophthalmology 2022; 67: 1476-1505
Infantile cataracts remain one of the most treatable causes of lifelong visual impairment. While the chance of improving vision for children with infantile cataracts has never been better, significant global and socioeconomic disparities still exist in the early management of infantile cataracts. Recent epidemiological studies reveal a stable prevalence of infantile cataracts in high-income countries and highlight challenges in determining the prevalence of infantile cataracts in low income countries. Detailed descriptions of cataract morphology may inform us as to etiology, provide guidance with regards to surgical approach, and have prognostic value. Molecular genetics is providing new insights into the hereditary bases and potential systemic associations of infantile cataracts. For visually significant infantile cataracts requiring surgery to clear the visual axis, surgical techniques continue to evolve based on the experiences and research efforts of skilled teams worldwide. The most common complications of cataract surgery performed in infancy are visual axis opacification and, in about a third of patients, the long-term development of glaucoma. While overall visual outcomes are better for children with unilateral cataracts given the presence of a healthy fellow eye, better visual outcomes in operated eyes are achieved in the setting of early presentation, bilateral infantile cataracts, absence of nystagmus or strabismus, and consistent amblyopia therapy. While intraocular lenses for infants less than 6 months can result in good visual outcomes, contact lenses may be preferred in situations in which they are available and practical. Many studies have demonstrated the benefits of early surgery for infantile cataract. We must strive for the continued evolution of technologies and strategies that have the potential to further improve these outcomes.
Department of Ophthalmology, Emory University School of Medicine, 1365B Clifton Road, NE, Suite 5400, Atlanta, Georgia 30322. Electronic address: phoebe.lenhart@emory.edu.
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