Commentary review: challenges of intraocular lens implantation for congenital cataract infants

Zhao, Qi-hui; Zhao, Ying‐Zheng

doi:10.18240/ijo.2021.06.19

Cited by 9 publications

(3 citation statements)

References 59 publications

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“…Zhao et al reported that age at surgery and laterality of cataract were two important factors when judging the optimal timing of IOL implantation. It was also recommended to delay the IOL implantation to reduce postoperative complications in a bilateral cataract 18 . The present results are similar to the recommendations of these literatures; children who underwent primary IOL implantation were significantly older than the others, and secondary IOL implantation was performed later in the bilateral cataract cases compared to the unilateral cataract cases.…”

Section: Discussionmentioning

confidence: 99%

Nationwide incidence of congenital and infantile cataract requiring surgery in Korea

Kim,

Lee,

Woo

et al. 2024

Sci Rep

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Congenital and infantile (CI) cataract is one of the most important and preventable cause of blindness in children, but the incidence has not been studied in Korea. We collected data from the national claims database of the National Health Insurance Service of Korea from 2002 through 2019. We identified children who underwent cataract surgery within the age of 5 years, and cumulative incidence rates were calculated for each of the three age criteria. 989 patients out of 4,221,459 births underwent surgery with CI cataract during the period. The cumulative incidence rates per 10,000 births were 1.60 (0–1 years), 2.38 (0–3 years), and 2.95 (0–5 years), respectively. The incidence peaked in the 2007 birth cohort, which coincides with the start of the national screening program for infants/children. Primary intraocular lens implantation was performed in 439 patients (44%). Strabismus and glaucoma requiring surgery occurred in 291 patients (29.4%) and 32 patients (3.2%), respectively, within 8 years after cataract surgery. The incidence rates of CI cataract in Korea appear to be comparable to previous studies in other regions. The early screening program for infants may reduce delayed diagnosis and increase the proportion of patients undergoing surgery at a critical time for visual development.

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Section: Discussionmentioning

confidence: 99%

Nationwide incidence of congenital and infantile cataract requiring surgery in Korea

Kim,

Lee,

Woo

et al. 2024

Sci Rep

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“…Cataract extraction followed by secondary intraocular lens (IOL) implantation is a common treatment strategy for infantile cataract patients (Lim et al., 2017; Zhao & Zhao, 2021). In most paediatric aphakic eyes, secondary IOL implantation into the ciliary sulcus is performed due to insufficient residual lens capsule after cataract extraction or failure to reopen the capsular bag due to firmly adherent capsular leaflets (Kleinmann et al., 2013; Liu et al., 2022; Shenoy et al., 2015).…”

Section: Introductionmentioning

confidence: 99%

Intraocular lens tilt and decentration in secondary ciliary sulcus implantation in paediatric eyes: A 3‐year prospective study

Yu,

Wang,

Tan

et al. 2024

Acta Ophthalmologica

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PurposeThe purpose of this study was to compare the tilt and decentration of one‐piece anti‐vaulting haptic intraocular lenses (IOL) and three‐piece C‐loop haptic IOLs in paediatric eyes undergoing secondary IOL implantation into the ciliary sulcus.MethodsPaediatric aphakic patients receiving either one‐piece anti‐vaulting haptic or three‐piece C‐loop haptic IOL implants into the ciliary sulcus were enrolled in this prospective non‐randomized interventional study and followed up for 3 years. IOL decentration and tilt were measured using Scheimpflug images. Preoperative and postoperative information, including demographic data and ocular biometric parameters and complications, were collected and analysed.ResultsAmong 123 eyes of 79 paediatric patients, there were 72 eyes (58.54%) in the anti‐vaulting haptic IOL group and 51 eyes (41.46%) in the C‐loop haptic group. The anti‐vaulting haptic IOL group had a lower incidence of clinically significant vertical IOL decentration than the C‐loop haptic IOL group (23.88% vs. 43.14%, p = 0.037). No intergroup differences were observed in vertical or horizontal tilt or in horizontal decentration (all p > 0.05). One‐piece anti‐vaulting haptic IOL implantation was associated with a lower risk of clinically significant vertical decentration than three‐piece C‐loop haptic IOL implantation (odds ratio: 0.42, p = 0.037). There was a higher incidence of IOL dislocation in the C‐loop haptic IOL group (15.22% vs. 4.17%, p = 0.046).ConclusionsIn paediatric aphakic eyes undergoing secondary IOL implantation into the ciliary sulcus, one‐piece anti‐vaulting haptic IOLs can reduce the risk of clinically significant vertical IOL decentration compared with three‐piece C‐loop haptic IOLs and may favour long‐term IOL positional stability.

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“…E ven with the development of modern microsurgical techniques and equipment, complications following pediatric cataract surgery still remain challenging [1][2][3][4] . The Infant Aphakia Treatment Study (IATS) found that common intraocular complications include visual axis opacification, glaucoma, and intraocular lens (IOL) exchange [5][6] .…”

Section: Introductionmentioning

confidence: 99%

Morphological changes in the iridocorneal angle and their relationship with intraocular pressure after infantile cataract surgery

Wang¹,

Zhang²,

Lu³

et al. 2022

Int J Ophthalmol

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AIM: To evaluate morphological changes in the iridocorneal angle after pediatric cataract surgery. METHODS: Children who underwent primary infantile cataract surgery were included and 64 eyes from 41 children, including 18 with unilateral cataracts (18 eyes) and 23 with bilateral cataracts (46 eyes) were examined. All patients underwent two gonioscopic examinations to evaluate the iridocorneal angle, before the primary lens removal and before the secondary intraocular lens implantation. The anatomical changes in the iridocorneal angle and the relationship between intraocular pressure (IOP) and iridocorneal angle changes were also analyzed. RESULTS: The iridocorneal angle was wide in 64 eyes before and after surgery. The trabecular meshwork pigmentation, number of iris processes in every quadrant of the iridocorneal angle, and the width of the ciliary body band in the superior and inferior quadrants at the second gonioscopic examination were significantly increased compared to those at the first examination (P<0.001, P<0.05, P<0.05, and P<0.05, respectively). IOP gradually increased at 1mo after operation, and returned to the preoperative level at 3mo. However, IOP still increased significantly at 6 and 12mo. CONCLUSION: The main changes after pediatric cataract surgery include an increase in trabecular meshwork pigmentation and number of iris processes, IOP gradually increase and has positive correlation with trabecular meshwork pigmentation and anterior insertion of iris process.

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Commentary review: challenges of intraocular lens implantation for congenital cataract infants

Cited by 9 publications

References 59 publications

Nationwide incidence of congenital and infantile cataract requiring surgery in Korea

Nationwide incidence of congenital and infantile cataract requiring surgery in Korea

Intraocular lens tilt and decentration in secondary ciliary sulcus implantation in paediatric eyes: A 3‐year prospective study

Morphological changes in the iridocorneal angle and their relationship with intraocular pressure after infantile cataract surgery

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