OJOph  Vol.3 No.1 , February 2013
Strabismus in Cases of Cataract in Pediatric Age Group*
ABSTRACT

Purpose: To investigate the epidemiology of strabismus in cases of pediatric cataracts. To assess visual outcome following orthoptic treatment for amblyopia in cases of cataracts in the pediatric age group. Methods: This was a retrospective cohort study. We investigated a consecutive series of pediatric patients with congenital, developing, or traumatic cataracts who underwent surgery between January 1999 and April 2012 at our center. Patient demographics, cataract type, presenting symptoms, surgical intervention, postoperative visual acuity, and follow-up refractive changes were recorded. Results: In total, 1331 eyes of 1043 children were included: unilateral cataracts were present in 785 (59%) eyes. There were 605 (45.5%) traumatic and 726 (54.5%) non-traumatic cases. Ages at surgery ranged from 1 to 215 months. All eyes were examined for ocular alignment; 66 (5%) were found to manifest strabismus. Deviation was significantly associated with age at intervention (p < 0.001), sensory nystagmus (p < 0.001), and etiology of cataracts (p < 0.001). We found significant differences in visual outcome following amblyopia therapy (p < 0.001). Conclusions: Surgical treatment with intraocular lens implantation in children with congenital, developmental, or traumatic cataracts is effective for visual rehabilitation. Orthoptic treatment made a significant difference in visual outcome (p < 0.001).


Cite this paper
S. Shah, M. Shah, P. Upadhyay, G. Bardoloi and D. Netralaya, "Strabismus in Cases of Cataract in Pediatric Age Group*," Open Journal of Ophthalmology, Vol. 3 No. 1, 2013, pp. 19-23. doi: 10.4236/ojoph.2013.31006.
References
[1]   V. Long and S. Chen, “Surgical Interventions for Bilateral Congenital Cataract,” Cochrane Database of Systemtic Reviews, Vol. 19, No. 3, 2006, Article ID: CD003171. doi:10.1002/14651858.CD003171.pub2

[2]   M. A. Zimmermann-Paiz, and C. R. Quiroga-Reyes, “Pediatric Cataract in a Developing Country Retrospective Re- view of 328 Cases,” Arquivos Brasileiros de Oftalmologia, Vol. 74, No. 3, 2011, pp. 163-165.

[3]   P. Gogate and K. Kalua, “Blindness in Childhood in Developing Countries Time for a Reassessment?” PLOS Medicine, Vol. 6, No. 12, 2009, Article ID: e1000177.

[4]   M. E. Wilson and S. K. Pandey, “Paediatric Cataract Blindness in the Developing World Surgical Techniques and Intraocular Lenses in the New Millennium,” British Journal of Ophthalmology, Vol. 87, No. 1, 2003, pp. 14-19.

[5]   K. M. de Carvalho and N. Minguini, “Characteristics of a Pediatric Low-Vision Population,” Journal of Pediatric Ophthalmology and Strabismus, Vol. 35, No. 3, 1998, pp. 162-165.

[6]   W. C. Owens and W. F. Hughes, “Results of Surgical Treatment of Congenital Cataract,” Archives of Ophthalmology, Vol. 39, No. 3, 1948, pp. 339-350. doi:10.1001/archopht.1948.00900020346009

[7]   G. Msukwa and M. Njuguna, “Cataract in Children At- tending Schools for the Blind and Resource Centers in Eastern Africa,” Ophthalmology, Vol. 116, 2009, pp. 1009- 1012. doi:10.1016/j.ophtha.2008.12.020

[8]   R. Dandona and L. Dandona, “Review of Findings of the Andhra Pradesh Eye Disease Study: Policy Implications for Eye-Care Services,” Indian Journal of Ophthalmology, Vol. 49, No. 4, 2001, pp. 215-234.

[9]   A. R. Vasavada, S. A. Vasavada, N. Bobrova, M. R. Praveen, S. K. Shah, V. A. Vasavada, et al., “Outcomes of Pediatric Cataract Surgery in Anterior Persistent Fetal Vasculature,” Journal of Cataract & Refractive Surgery, Vol. 38, No. 5, 2012, pp. 849-857. doi:10.1016/j.jcrs.2011.11.045

[10]   R. M. Robb and R. A. Petersen, “Outcome of Treatment for Bilateral Congenital Cataracts,” Transactions of the American Ophthalmological Society, Vol. 90, 1992, pp. 183-194

[11]   J. Francois “Late Results of Congenital Cataract Surgery,” Ophthalmology, Vol. 86, No. 9, 1979, pp. 1586-1598.

[12]   D. A. Hiles and P. H. Wallar, “Visual Results Following Infantile Cataract Surgery,” International Ophthalmology Clinics, Vol. 17, No. 4, 1977, pp. 265-282.

[13]   H. G. Scheie, “Aspiration of Congenital or Soft Cataracts: A New Technique,” American Journal of Ophthalmology, Vol. 50, 1960, pp. 1048-1056.

[14]   D. Taylor, “Choice of Surgical Technique in the Management of Congenital Cataract,” Transactions of Ophthalmological Societies of United Kingdom, Vol. 101, No. 1, 1981, pp. 114-117.

[15]   M. M. Parks, “Posterior Lens Capsulectomy during Primary Cataract Surgery in Children,” Ophthalmology, Vol. 90, No. 4, 1983, pp. 344-345.

[16]   G. L. Rogers, C. L. Tishler and B. H. Tsou, “Visual Acuities in Infants with Congenital Cataracts Operated on Pri- or to 6 Months of Age,” Archives of Ophthalmology, Vol. 99, No. 6, 1981, pp. 999-1003. doi:10.1001/archopht.1981.03930010999002

[17]   S. S. Gelbart, C. S. Hoyt, G. Jastrebski and E. Marg, “Long-Term Visual Results in Bilateral Congenital Cataracts,” American Journal of Ophthalmology, Vol. 93, No. 5, 1982, pp. 615-621.

[18]   D. Taylor, Vaegan and J. A. Morris, “Amblyopia in Bi- lateral Infantile and Juvenile Cataract, Relationship to Timing of Treatment,” Transactions of Ophthalmological Societies of United Kingdom, Vol. 99, No. 1, 1979, pp. 170-175.

[19]   M. Yamamoto and M. Dogru, “Visual Function Following Congenital Cataract Surgery,” Japanese Journal of Ophthalmology, Vol. 42, No. 5, 1998, pp. 411-416. doi:10.1016/S0021-5155(98)00039-2

[20]   R. H. Trivedi and M. E. Wilson, “Accuracy of the Holla-

[21]   day 2 Intraocular Lens Formula for Pediatric Eyes in the Absence of Preoperative Refraction,” Journal of Cataract & Refractive Surgery, Vol. 37, No. 7, 2011, pp. 1239- 1243. doi:10.1016/j.jcrs.2011.01.021

[22]   S. K. McClatchey, “Choosing IOL Power in Pediatric Cataract Surgery,” International Ophthalmology Clinics, Vol. 50, No. 4, 2010, pp. 115-123. doi:10.1097/IIO.0b013e3181f0f2e0

[23]   N. G. Congdon and S. Ruiz, “Determinants of Pediatric Cataract Program Outcomes and Follow-Up in a Large Series in Mexico,” Journal of Cataract & Refractive Surgery, Vol. 33, No. 10, 2007, pp. 1775-1780. doi:10.1016/j.jcrs.2007.06.025

[24]   M. L. Yang and C. H. Hou, “Clinical Characteristics and Surgical Outcomes of Pediatric Cataract in Taiwan,” Graefe’s Archive for Clinical and Experimental Ophthalmology, Vol. 244, No. 11, 2006, pp. 1485-1490. doi:10.1007/s00417-006-0308-4

[25]   R. Khandekar and A. Sudhan, “Pediatric Cataract and Surgery Outcomes in Central India a Hospital Based Study,” Indian Journal of Medical Sciences, Vol. 61, No. 1, 2007, pp. 15-20. doi:10.4103/0019-5359.29593

[26]   A. Magli and A. Iovine, “Strabismus in Developmental Cataract,” European Journal of Ophthalmology, Vol. 18, No. 4, 2006, pp. 540-543.

[27]   N. Spanou and L. Alexopoulos, “Strabismus in Pediatric Lens Disorders,” Journal of Pediatric Ophthalmology and Strabismus, Vol. 48, No. 3, 2011, pp. 163-166. doi:10.3928/01913913-20100618-05

[28]   P. Hochstrasser and B. Gloor, “Surgical Results of Uni- and Bilateral Congenital and Traumatic Cataract in Infancy to Adolescence,” Klin Monatsbl Augenheilkd, Vol. 204, No. 5, 1994, pp. 274-278. doi:10.1055/s-2008-1035534

 
 
Top