Pediatric cataract

Khokhar, SudarshanKumar; Pillay, Ganesh; Dhull, Chirakshi; Agarwal, Esha; Mahabir, Manish; Aggarwal, Pulak

doi:10.4103/ijo.ijo_1023_17

Cited by 116 publications

(72 citation statements)

References 82 publications

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“…The anesthetics used in pediatric ophthalmic surgery can meet the requirements of fast effect, stable effect, quick awakening, easy adjustment, small stimulation and low incidence of complications [35, 36]. Although sevoflurane is the most commonly used inhaled anesthetic in pediatric anesthesia and it has incomparable advantages over other anesthetic in the induction period of pediatric surgical anesthesia, sevoflurane alone can lead to high risk of EA.…”

Section: Discussionmentioning

confidence: 99%

Effect of ancillary drugs on sevoflurane related emergence agitation in children undergoing ophthalmic surgery: a Bayesian network meta-analysis

et al. 2019

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Background The comparative efficacy of ancillary drugs on sevoflurane related emergence agitation (EA) in children undergoing ophthalmic surgery remains controversial. Methods The databases were retrieved in an orderly manner from the dates of their establishment to October, 2018, including PubMed, The Cochrane Library and Web of Science, to collect randomized controlled trials (RCT) of different anesthetic drugs combined with sevoflurane for ophthalmic surgery. Then a network meta-analysis was conducted using R and Stata 12.0 softwares. Results The meta-analysis showed that, in reducing sevoflurane related EA, dexmedetomidine, ketamine, propofol, fentanyl, midazolam, sufentanil, remifentanil and clonidine were superior to placebo ( P < 0.05). The network meta-analysis showed that the effects of ancillary drugs combine with sevoflurane in reducing risk of EA in children undergoing ophthalmic surgery was superior to placebo: dexmedetomidine (OR = 0.17, 95% CrI 0.12–0.22), ketamine (OR = 0.30, 95% CrI 0.11–0.49), propofol (OR = 0.24, 95% CrI 0.09–0.63), fentanyl (OR = 0.16, 95% CrI 0.08–0.56), midazolam (OR = 0.20, 95% CrI 0.09–0.40), sufentanil (OR = 0.27, 95% CrI 0.14–0.41), remifentanil (OR = 0.18, 95% CrI 0.08–0.54) and clonidine (OR = 0.14, 95% CrI 0.07–0.41). The SUCRA of placebo, dexmedetomidine, ketamine, propofol, fentanyl, midazolam, sufentanil, remifentanil, clonidine were respectively 0.26, 77.93, 27.71, 42.8, 69.43, 52.89, 59.83, 57.62 and 61.53%. Conclusions The effects of dexmedetomidine combine with sevoflurane in reducing risk of emergence agitation in children undergoing ophthalmic surgery was superior to other drugs.

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Section: Discussionmentioning

confidence: 99%

Effect of ancillary drugs on sevoflurane related emergence agitation in children undergoing ophthalmic surgery: a Bayesian network meta-analysis

et al. 2019

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“…Most ophthalmologic emphasis of T1D has been stressed on the influence of retinopathy [ 2 , 28 ], and the lesser known is the complication of cataract, which has resulted in more than half of the blindness worldwide [ 12 ]. Untreated cataracts in children cast tremendous burden to the child and family [ 29 ]. Our study revealed that T1D patients certainly had a higher risk of developing cataracts than nondiabetic population.…”

Section: Discussionmentioning

confidence: 99%

High Risk of Early Cataracts in Young Type 1 Diabetes Group: A Nationwide Cohort Study

Shen

Lee

et al. 2020

International Journal of Endocrinology

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Background. Chronic hyperglycemia in type 1 diabetes (T1D) patients results in ocular problems over time, but only a few studies emphasized on cataracts. Aim. To evaluate the epidemiology of cataracts in the T1D population. Method. A two-part study was conducted using data from the National Health Insurance Research Database in Taiwan. Information from the Longitudinal Health Insurance Database (LHID) was served as a template of the general population. In the first part, a total of 3,622 T1D cases registered between 1998 and 2007 were enrolled and compared with a matched group from the LHID. For identifying risk factors of cataracts in the T1D population in the second part, a total of 9032 T1D cases registered between 1998 and 2013 were included. Result. Compared to the LHID, the hazard ratio (HR) of cataracts in the T1D group was 5.81 (95% CI 4.60–7.33), and the HR was higher in females (6.29, 95% CI 4.63–8.55). The peak incidence of cataracts occurred between age 20 and 29 in the T1D group, while in the LHID, it was after 60. The overall incidence of cataracts in the T1D group was 9.1%. In T1D patients with cataracts, they were found with higher rates of associated diabetic complications. Conclusion. Compared to the nondiabetic population, cataracts seemed more rampant and premature in T1D patients, especially those of female gender. Early ophthalmologic examination should be considered in T1D patients.

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“…In young cataract patients, treatment options are more debated and require further consideration. It is known that the critical period of eye development ranges from 2 to 6 months of age, and emmetropization is generally achieved by 9 years of age [ 15 ]. To avoid amblyopia, some ophthalmologists recommend early surgical intervention for pediatric ocular traumatic cataracts, and in simple PCC cases without corneal or retinal injury, cataract extraction with intraocular lens implantation can restore excellent visual acuity [ 6 , 7 ].…”

Section: Discussionmentioning

confidence: 99%

Spontaneous resolution of a traumatic cataract in a patient with an open-globe ocular injury: a case report

Zhang

Liu

et al. 2020

BMC Ophthalmol

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Background: We report a case of spontaneous resolution of a traumatic cataract in a patient with an open-globe ocular injury. This case highlights the importance of conservative management in these types of cases, as excellent visual outcome is possible without invasive surgical intervention. Case presentation: A 13-year-old boy presented with a corneal laceration in the left eye caused by a neuter pen. He underwent emergency repair of the corneal laceration under general anesthesia, and at 3 days post-op, a dense posterior cortical cataract was observed. Based on the patient's age and normal visual development, in addition to preserving accommodative potential, the patient received conservative management and follow-up. Interestingly, the cataract spontaneously resolved over the following 9 months and the corrected distance visual acuity in the injured eye was restored from finger counting at 50 cm, to 20/25 + 3. Conclusions: To optimize treatment in pediatric traumatic cataract, several critical factors such as age, visual development and the preservation of accommodative potential, need to be comprehensively considered. Conservative management with lens preservation is important to consider in young, traumatic cataract patients where invasive surgical intervention may not be required.

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Pediatric cataract

Cited by 116 publications

References 82 publications

Effect of ancillary drugs on sevoflurane related emergence agitation in children undergoing ophthalmic surgery: a Bayesian network meta-analysis

Effect of ancillary drugs on sevoflurane related emergence agitation in children undergoing ophthalmic surgery: a Bayesian network meta-analysis

High Risk of Early Cataracts in Young Type 1 Diabetes Group: A Nationwide Cohort Study

Spontaneous resolution of a traumatic cataract in a patient with an open-globe ocular injury: a case report

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