Developmental profile of ocular refraction in patients with congenital cataract: a prospective cohort study

Liu, Zhenzhen; Long, Erping; Chen, Jingjing; Lin, Zhuoling; Lin, Duoru; Wu, Xiaohang; Cao, Qian; Li, Xiaoyan; Wang, Dongni; Luo, Lixia; Liu, Runzhong; Liu, Xiaopin; Chen, Weirong; Liu, Yizhi

doi:10.1016/s0140-6736(16)31981-x

Cited by 8 publications

(5 citation statements)

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“…Many studies have investigated MS in pseudophakic eyes. 2,4,5,7–28 Some authors chose similar study design and found similar results—McClatchey et al in 2000, 8 Lambert et al in 1999, 9 and the multicenter, randomized controlled clinical trial—The Infant Aphakia Treatment Study (IATS) in 2016. 10 These studies confirm that an infant receiving a cataract surgery with secondary IOL implantation until the age of 2 years will undergo a MS of −4D to 10D and demonstrate that the earlier the surgery, the larger the MS.…”

Section: Discussionmentioning

confidence: 92%

Factors influencing myopic shift in children after intraocular lens implantation

Valeiņa

Heede

Erts

et al. 2019

European Journal of Ophthalmology

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Introduction: Intraocular lenses have always been a controversial topic in pediatric cataract surgery. In the early 1990s in the post-Soviet states of Eastern Europe, intraocular lenses promised an easier full-time correction and amblyopia treatment. Since 1991, ophthalmologists in Latvia have been implanting intraocular lenses in infants. Amount of the postoperative myopic shift and its influencing factors, analyzed in this article, are important indicators of congenital cataract treatment. Materials and methods: A retrospective chart review off 85 children (137 eyes) who underwent foldable posterior chamber intraocular lens implantation at the Clinical University Hospital in Riga, Latvia, from 1 January 2006 until 31 December 2016, was performed. Depending on the age at surgery, patients were divided into six groups: 1–6, 7–12, 13–24, 25–48, 49–84, and 85–216 months. Results: The largest and more variable myopic shift was found in a group of diffuse/total and nuclear cataract with surgery before the age of 6 months. There was a statistically significant correlation between the acquired best-corrected visual acuity and the amount of myopic shift (rs = 0.33; p < 0.001). Comparing the amount of myopic shift in two groups of different intraocular lens implantation target refraction tactics, we did not find statistically significant differences. Comparing the amount of myopic shift and implanted intraocular lens power, a negative, statistically significant correlation was found. Conclusion: The earlier the cataract extraction surgery and intraocular lens implantation is performed, the larger the myopic shift. The morphological type of cataract, best-corrected visual acuity, secondary glaucoma, and intraocular lens power influence the amount of myopic shift.

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Section: Discussionmentioning

confidence: 92%

Factors influencing myopic shift in children after intraocular lens implantation

Valeiņa

Heede

Erts

et al. 2019

European Journal of Ophthalmology

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“…Normal emmetropization of refractive media is generally considered to be 3-6 dioptres during the first 4 years after birth. Refractive changes of less than 3 dioptres are considered undergrowth, whereas refractive changes of more than 6 dioptres are considered overgrowth [32]. The results showed that the majority of our patients (54 eyes, 84.4%) exhibited normal refractive development following initial stage blindness.…”

Section: Refractive Dynamic Development Following Initial Stage Blindmentioning

confidence: 83%

Dynamic response to initial stage blindness in visual system development

et al. 2017

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Correspondence: Haotian Lin (gddlht@aliyun.com)Sensitive periods and experience-dependent plasticity have become core issues in visual system development. Converging evidence indicates that visual experience is an indispensable factor in establishing mature visual system circuitry during sensitive periods and the visual system exhibits substantial plasticity while facing deprivation. The mechanisms that underlie the environmental regulation of visual system development and plasticity are of great interest but need further exploration. Here, we investigated a unique sample of human infants who experienced initial stage blindness (beginning at birth and lasting for 2-8 months) before the removal of bilateral cataracts. Retinal thickness (RT), axial length (AL), refractive status, visual grating acuity and genetic integrity were recorded during the preoperative period or at surgery and then during follow-up. The results showed that the development of the retina is malleable and associated with external environmental influences. Our work supported that the retina might play critical roles in the development of the experience-dependent visual system and its malleability might partly contribute to the sensitive period plasticity.

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“…Even so, primary IOL implantation in children aged < 6 months is controversial, and most surgeons recommend leaving children aphakic with further lens/spectacle correction [ 11 ]. Myopic shift (MS), resulting from both the natural physiological growth of the eye and any deviations that occur, is an important factor influencing the outcome of congenital cataract surgery [ 12 ]. Many studies have investigated MS in pseudophakic eyes and demonstrated that earlier IOL implantation is associated with greater MS [ 13 ].…”

Section: Discussionmentioning

confidence: 99%

Rare micropupil secondary to congenital cataract surgery favoring the development of the affected eye: a case report

Ma,

Zhu

2024

BMC Ophthalmol

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Background Congenital microcoria has been extensively reported and usually leads to visual dysfunction or blindness. However, micropupil development secondary to cataract surgery has never been reported. Here, we describe a rare case of micropupil development in infancy that occurred secondary to combined cataract extraction and intraocular lens implantation for treatment of congenital cataract. When the patient reached adulthood, the affected eye not only gained good vision but also showed better ocular development and refractive status than the fellow eye. Case presentation A 17-year-old boy presented to our outpatient clinic with decreased vision in his left eye related to congenital cataract surgery at 6 months of age. The affected eye had exhibited a pinhole pupil since the third month postoperatively. The condition had been managed with observation and regular monocular occlusion treatment. Upon presentation to our clinic, the best-corrected visual acuity (BCVA) in his fellow eye was 0.0 logMAR(20/20) with a refraction of − 5.75 diopters cylinder/−2.25 diopters sphere, and the BCVA in his affected eye was 0.5 logMAR(20/40) with a refraction of 0.00 diopters. Ophthalmic examination of the affected eye revealed a pinhole pupil (approximately 0.5 mm) with high light reflex sensitivity but no response to pupil-dilating drugs. The patient underwent pupilloplasty of the affected eye under corneal surface anesthesia. Postoperative examination revealed better ocular development in the affected eye than in the fellow eye (axial length: 24.21 vs. 27.02 mm, respectively) as well as better refractive status in the affected eye (BCVA of 0.0 logMAR(20/20) with a refraction of − 2.23 diopters cylinder/−3.00 diopters sphere vs. 0logMAR(20/20) with a refraction of -5.75 diopters cylinder/-2.25 diopters sphere). Conclusions We have reported a rare case of micropupil development secondary to congenital cataract surgery, which is an uncommon complication, especially in children. However, unlike congenital microcoria, the secondary pinhole pupil may have reduced imaging haze and halos, possibly favoring the development of the affected eye. This case provides further insight into the treatment of congenital cataract.

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Developmental profile of ocular refraction in patients with congenital cataract: a prospective cohort study

Cited by 8 publications

References 0 publications

Factors influencing myopic shift in children after intraocular lens implantation

Factors influencing myopic shift in children after intraocular lens implantation

Dynamic response to initial stage blindness in visual system development

Rare micropupil secondary to congenital cataract surgery favoring the development of the affected eye: a case report

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