Catarata congênita nas infecções intrauterinas mais comuns (STORCH): revisão de literatura / Congenital cataract in the most common intrauterine infections (STORCH): a review of the literature

RESUMO Objetivo: O objetivo deste estudo foi revisar os aspectos clínicos e patológicos da catarata congênita secundária às infecções por sífilis, toxoplasmose, rubéola, citomegalovírus e herpes simples. Métodos: Trata-se de uma revisão de literatura, na qual foram incluídos artigos de periódicos indexados às bases de dados PubMed®, Cochrane, Lilacs, Embase e SciELO de 2010 a 2023. Resultados: Foram encontrados 45 artigos, e, após seleção, restaram 9 artigos. Além disso, foram adicionados artigos para enriquecer a discussão. A infecção por sífilis está relacionada a alterações corneanas. O citomegalovírus e a toxoplasmose estão relacionados com a coriorretinite e/ou microftalmia. A rubéola é responsável por causar catarata, glaucoma, microftalmia e retinite em sal e pimenta. Conclusão: Foram abordadas as principais etiologias infecciosas e seu quadro clínico na CC. O melhor tratamento para CC é cirúrgico associado a acompanhamento clínico, mas a prevenção é a maneira mais eficaz de combater a CC de etiologia infecciosa. O diagnóstico precoce e o tratamento efetivo previnem alterações e sequelas visuais irreversíveis. Nesse contexto, mostram-se importantes as ações de políticas públicas para o melhor desfecho clínico e melhor qualidade de vida.

ABSTRACT Objective: To review the clinical and pathological aspects of CC secondary to infections by syphilis, toxoplasmosis, rubella, cytomegalovirus, herpes simplex. Methods: This is a literature review. Articles from journals indexed to PubMed, COCHRANE, LILACS, EMBASE and SCIELO from 2010 to 2023 were included. Results: A total of 45 articles were found, which, after selection, remained in 9 articles. Some articles were included to enrich the discussion in this topic. The infection caused by syphilis is related to corneal changes. Cytomegalovirus and Toxoplasmosis due to chorioretinitis and/or microphthalmia. Rubella is responsible for causing cataracts, glaucoma, microphthalmia, and salt and pepper retinitis. Conclusion: The main infectious etiologies and their clinical status in CC were addressed. The best treatment for CC is surgery associated with clinical follow-up, but prevention is the most effective way to combat CC of infectious etiology. Early diagnosis and effective treatment prevent irreversible visual changes and sequelae. In this context, public policy actions are important for the best clinical outcome and better quality of life.

Long-term outcomes of intraoperative triamcinolone injection versus postoperative oral prednisolone in congenital cataract surgery / Resultados de longo prazo do uso intraoperatório de triancinolona versus oral pós-operatório de prednisolona na cirurgia de catarata congênita

ABSTRACT Purpose: To compare the long-term ocular findings of children that were operated of congenital cataract before the age of two and that received an intraoperative intracameral triamcinolone injection or used postoperative oral prednisolone to modulate ocular inflammation. Methods: All patients who had previously participated in a clinical trial that analyzed the 1-year surgical outcomes of congenital cataract surgery utilizing intracameral triamcinolone (study group) or oral prednisolone (control group) were eligible to participate in this prospective cohort research. Patients' medical records were reviewed, and the children underwent a complete ophthalmologic exam on final follow-up. Biomicroscopic findings, intraocular pressure, central corneal thickness, the need for additional surgical interventions, and findings compatible with glaucoma were the primary end measures. Results: Twenty-six eyes (26 patients) were included (study group = 11 eyes; control group = 15 eyes). The mean follow--up was 8.2 ± 1.2 years and 8.1 ± 1.7 years in the study and control groups, respectively (p=0.82). All eyes presented a centered intraocular lens. There was no statistically significant difference between the groups with regards to the presence of posterior synechia (p=0.56), intraocular pressure (p=0.49), or central corneal thickness (p=0.21). None of the eyes fulfilled the glaucoma diagnostic criteria, presented secondary visual axis obscuration, or were reoperated. Conclusion: The long--term ocular findings of children that underwent congenital cataract surgery and received an intraoperative intracameral triamcinolone injection were similar to those that used postoperative oral prednisolone to modulate ocular inflammation. This suggests that intracameral triamcinolone may substitute oral prednisolone in congenital cataract surgery, facilitating the postoperative treatment regimen and compliance.

RESUMO Objetivo: Comparar os achados oculares em longo prazo de crianças que se submeteram à cirurgia de catarata congênita antes dos dois anos de idade e receberam uma injeção intracameral de triancinolona no intraoperatório ou usaram prednisolona oral no pós-operatório para modular a inflamação ocular. Métodos: Neste estudo prospectivo de coorte, todos os pacientes que participaram de um ensaio clínico anterior, que analisou os resultados cirúrgicos de 1 ano da cirurgia de catarata congênita usando triancinolona intracameral (Grupo de Estudo) ou prednisolona oral (Grupo Controle), eram elegíveis para participar. Os prontuários médicos dos pacientes foram revisados e as crianças foram submetidas a um exame oftalmológico completo no acompanhamento final. As principais medidas de desfecho foram: achados biomicroscópicos, pressão intraocular, espessura central da córnea, a necessidade de intervenções cirúrgicas adicionais e achados compatíveis com glaucoma. Resultados: Vinte e seis olhos (26 pacientes) foram incluídos (Grupo de Estudo = 11 olhos; Grupo de Controle = 15 olhos). O seguimento médio foi de 8,2 ± 1,2 anos e 8,1 ± 1,7 anos nos Grupos de Estudo e Controle, respectivamente (p=0,82). Todos os olhos apresentavam lente intraocular centrada. Não houve diferença estatisticamente significativa entre os grupos com relação à presença de sinéquia posterior (p=0,56), pressão intraocular (p=0,49) ou espessura central da córnea (p=0,21). Nenhum dos olhos preencheu os critérios diagnósticos para glaucoma, apresentou opacificação secundária do eixo visual ou foi reoperado. Conclusão: Os achados oculares em longo prazo de crianças que se submeteram à cirurgia de catarata congênita e receberam uma injeção intracameral de triancinolona no intraoperatório foram semelhantes aos que usaram prednisolona oral no pós-operatório para modular a inflamação ocular, sugerindo que a triancinolona intracameral pode substituir a prednisolona oral na cirurgia de catarata congênita, facilitando o tratamento pós-operatório e a adesão ao mesmo.

Surgical management of lifebuoy cataract

Lifebuoy cataract is a rare form of congenital cataract with anatomical characteristics. Herein, we present a case of an otherwise healthy 42-year-old female with a long-standing history of blurred vision. Examination showed the presence of esotropia and bilateral horizontal nystagmus. Visual acuity was limited to light perception in both eyes. Slit-lamp examination showed a calcified lens capsule with the absence of lens material in the right eye and the presence of an annular cataract in the left eye, corresponding to a unilateral lifebuoy cataract. She underwent cataract surgery with intraocular lens implantation. We report the clinical findings, anterior segment optical coherence tomography (AS-OCT), and surgical management tips. We noticed that during surgery, both anterior capsulorhexis and central membrane removal were the most challenging steps due to the absence of central nucleus and the strong adherence of central membrane to the anterior hyaloid

Role of swept-source anterior segment optical coherence tomography in imaging pediatric cataract

Purpose: To determine the morphology of pediatric cataracts and assess the status of the anterior and posterior capsules preoperatively on swept?source anterior segment optical coherence tomography (ASOCT) and compare the findings to those of intraoperative examination. Secondly, we aimed to obtain biometric measurements on ASOCT and compare them to those obtained on A?scan/optical methods. Methods: This was a prospective and observational study carried out at a tertiary care referral institute. ASOCT scans for anterior segment were obtained preoperatively for all patients, aged <8 years, scheduled for paediatric cataract surgery. The morphology of the lens and capsule and biometry were performed on ASOCT and the same were assessed intraoperatively. The main outcome measures were comparison of ASOCT findings to intraoperative findings. Results: The study included 33 eyes of 29 patients (range 3 months–8 years). The morphological characterization of cataract on ASOCT was accurate in 31/33 (94%) cases. ASOCT accurately identified fibrosis and rupture of the anterior and posterior capsules in 32/33 (97%) cases each. In 30% of eyes, ASOCT gave additional information preoperatively compared to the slit lamp. Intraclass correlation coefficient (ICC) calculation revealed a good agreement between the keratometry values obtained on ASOCT and those obtained preoperatively with a handheld/optical keratometer (ICC = 0.86, P = 0.001). Conclusion: ASOCT is a valuable tool that could provide complete preoperative information of the lens and capsule in pediatric cataract cases. In children as young as 3 months of age, intraoperative risks and surprises could be diminished. The keratometric readings are highly dependent on patient cooperation but show good agreement with the handheld/optical keratometer readings.

Research progress on quality of life in children with congenital cataract / 国际眼科杂志(Guoji Yanke Zazhi)

Congenital cataract is an important cause of irreversible visual impairment in children. Although surgery and rehabilitation can significantly improve the clinical symptoms of children, increasing studies have shown that children with congenital cataract still have many problems associated with poor quality of life, such as poor ability, psychological and social function impairment, etc., which have a nonnegligible impact on their growth. In this review, the current status of assessment methods and research on quality of life in children with congenital cataract was summarized, with a view to providing a reference for targeted intervention.

Clinical characteristics of congenital and developmental cataract in Kazakhstan

Purpose: To study and describe clinical characteristics of congenital and developmental cataract at a tertiary eye care facility. Methods: In this retrospective study, 942 children (1311 eyes) presenting with congenital/developmental cataract over a 10?year study period were included. Gender, age at surgery, main presenting complaint, morphologic type of cataract, laterality, family history, and associated findings were recorded. Results: The overall proportion of boys and girls undergoing cataract surgery was approximately equal (P = 0.110). However, in the cases of bilateral cataract, the proportion of boys was larger than girls (P = 0.028). More than half (62.3%) of the patients underwent surgery at the age of >3 years. The main presenting complaint was white pupils, accounting for 48.1% of cases. Total cataract was the most common morphologic type in all age groups. In total, 133 children out of 942 (14.1%) had a positive family history of congenital/developmental cataract. Strabismus and nystagmus were seen in 27.2% and 19.3% of the eyes, respectively. Additional ocular dysmorphology was found in 97 (10.3%) of patients. Coexisting systemic disease was found in 149 (15.8%) cases. Among syndrome?associated cataracts, Down syndrome accounted for the majority of cases. Conclusion: High prevalence of total cataracts as well as frequent association with strabismus and nystagmus are likely to be the consequences of delayed presentation.

Congenital Cytomegalovirus Infection initially managed as Congenital Rubella Syndrome

@#Congenital cytomegalovirus (CMV) infection (cCMV) is challenging to differentiate from congenital rubella syndrome (CRS) clinically. Virus detection and serological tests are needed. However, they are often not readily available or are expensive. This is a case of a five-month-old male with bilateral cataracts. He was jaundiced at birth and started having seizure episodes at one month of age. He was also diagnosed with right inguinal hernia and had abnormal bilateral hearing tests. Both eyes were noted to have leukocoria at two months of age. There was dazzle on both eyes and sclerae were anicteric. Examination revealed dense cataracts on both eyes, but their ocular ultrasound results were essentially normal. Due to the bilateral hearing loss and bilateral cataracts, CRS was initially considered despite the absence of heart abnormality since there were reported CRS cases without the complete triad. However, possible coinfection or another disease was considered due to the presence of jaundice, seizures, and hernia, which were never seen in our previous CRS patients nor were reported in the literature. The patient underwent cataract extraction on both eyes without intraocular lens implantation (IOL) as recommended for CRS cataracts to prevent severe inflammation. TORCH (TOxoplasmosis, Rubella, Cytomegalovirus, Herpes simplex) test was negative for rubella but positive for CMV. As such, the patient would have benefitted from early IOL implantation. The patient was then referred to a national medical center for possible treatment. However, since the patient already tested negative for CMV polymerase chain reaction (PCR) there, systemic antiviral therapy was no longer initiated. This case presented the challenge of clinically differentiating cCMV and CRS.

Long-term results of in-the-bag primary intraocular lens implantation in children younger than 24 months / Resultados a longo prazo de implante primário de lente intraocular no saco capsular em crianças menores que 24 meses

ABSTRACT Purpose: The purpose of this study was to analyze the safety of primary intraocular lens implantation in a large number of eyes in children aged <24 months. Methods: The medical records of patients aged 5-24 months, who underwent primary intraocular lens implantation in the capsular bag, were reviewed. A foldable three-piece acrylic intraocular lens was implanted by the same surgeon using a single surgical technique. Patients who had <1 year of follow-up after the surgery were excluded. The main outcome measurements included visual acuity, myopic shift, follow-up complications, and additional surgeries. Results: Sixty-eight patients (93 eyes) were analyzed. The mean age of the patients at the time of surgery was 15.06 ± 6.19 months (range: 5-24 months), and the spherical equivalent 1 month after surgery was 3.62 ± 2.32 D. After 5.67 ± 3.10 years, the spherical equivalent was -0.09 ± 3.22 D, and the corrected distance visual acuity was 0.33 ± 0.33 and 0.64 ± 0.43 logMAR in bilateral and unilateral cases, respectively (p=0.000). The highest myopic shift was observed in infants who underwent surgery at ages 5 and 6 months. The most frequent complications included visual axis opacification and corectopia. Glaucoma and retinal detachment were not reported. Conclusion: Primary in-the-bag intraocular lens implantation in children aged 5-24 months is safe, and is associated with low rates of adverse events and additional surgery.

RESUMO Objetivo: O objetivo deste estudo foi analisar a segurança do implante de lente intraocular primária em um grande número de olhos em crianças <24 meses. Métodos: Foram revisados os prontuários de pacientes com idade entre 5-24 meses, submetidos a implante primário de lente intraocular no saco capsular. Uma lente intraocular acrílica de três peças dobrável foi implantada pelo mesmo cirurgião usando uma única técnica cirúrgica. Pacientes que tiveram <1 ano de acompanhamento após a cirurgia foram excluídos. Os principais resultados incluíram medidas de acuidade visual, mudança miópica, complicações pós operatórias e cirurgias adicionais. Resultados: Foram analisados 68 pacientes (93 olhos). A média de idade dos pacientes no momento da cirurgia foi de 15,06 ± 6,19 (5 a 24) meses, e o equivalente esférico 1 mês após a cirurgia foi de 3,62 ± 2,32 D. Após 5,67 ± 3,10 anos, o equivalente esférico foi de -0,09 ± 3,22 D, e a acuidade visual corrigida à distância foi de 0,33 ± 0,33 e 0,64 ± 0,43 logMAR em casos bilaterais e casos unilaterais, respectivamente (p=0,000). A maior mudança míopica foi observado em bebês submetidos à cirurgia aos 5 e 6 meses de idade. As complicações mais frequentes incluíram opacificação do eixo visual e corectopia. Glaucoma e descolamento de retina não foram relatados. Conclusão: O implante primário de lente intraocular no saco capsular em crianças de 5-24 meses é seguro e está associado à baixas taxas de eventos adversos e cirurgias adicional.

25G lens resection combined with anterior vitrectomy in the treatment of congenital cataract / 国际眼科杂志(Guoji Yanke Zazhi)

@#AIM: To observe the clinical efficacy of 25G lens resection combined with anterior vitrectomy in the treatment of congenital cataract.<p>METHODS: This retrospective case series study included 55 eyes of 38 children with congenital cataract, age from 3mo to 5 years old, who were recruited between May 2013 and August 2017. The children were divided into two groups according to the different surgical methods. Group A(25 eyes of 17 children)received a 25G sutureless lensectomy combined with capsulotomy and anterior vitrectomy, and group B(30 eyes of 21 children)received a cataract phacoemulsification combined with capsulotomy and anterior vitrectomy. The mean follow-up time was 43.4(range: 36-74)mo. The postoperative best corrected visual acuity(BCVA), axial length, and complications were compared. <p>RESULTS: The age, sex distribution, duration, preoperative BCVA, and preoperative axial lengths were not significantly different between the two groups(<i>P</i>>0.05). The BCVA improved significantly at postoperative compared with BCVA at baseline in both gorups(Group A: <i>P</i><0.001; Group B: <i>P</i><0.001). The BCVA was better in Group A than Group B at 6mo postoperatively(<i>P</i>=0.043). No statistically significant difference was found in BCVA between the two groups at 12, 24 and 36mo after initial treatment(<i>P</i>=0.727, <i>P</i>=0.286, <i>P</i>=0.889). No statistically significant difference was found in axial lengths between 6mo of postoperation and preoperation in both groups(Group A: <i>P</i>=0.206, Group B: <i>P</i>=0.082). The mean postoperative axial lengths at 12, 24 and 36mo were longer than that at baseline in both group(Group A: <i>P</i>=0.023, <i>P</i>=0.015, <i>P</i><0.01, Group B: <i>P</i>=0.018, <i>P</i><0.01, <i>P</i><0.01). There were no significantly different in mean axial length after operation between the two groups(6mo: <i>P</i>=0.195, 12mo: <i>P</i>=0.313, 24mo: <i>P</i>=0.485, 36mo: <i>P</i>=0.089). The rate of postoperative complications was lower in Group A than Group B(<i>P</i>=0.042).<p>CONCLUSION: 25G sutureless lensectomy combined with capsulotomy and anterior vitrectomy is an effective and safe treatment method for congenital cataract, the visual acuity after treatment was improved significantly.

Clinical analysis of the secondary glaucoma and postoperative visual acuity after infantile congenital cataract surgery / 国际眼科杂志(Guoji Yanke Zazhi)

@#AIM: To analyze correlation of secondary glaucoma and postoperative visual acuity after infantile congenital cataract surgery. <p>METHODS: Retrospective case series. Totally 48 cases(86 eyes)were observed in our hospital from May 2006 to January 2018. All patients received intraocular lens(IOL)implantation with posterior continuous curvilinear capsulorhexies and anterior vitrectomy after cataract extraction. The best corrected visual acuity(BCVA)was determined, secondary glaucoma was evaluated during the 13a follow-up period. The independent samples <i>t</i>-test, Fisher exact test and multivariate Logistic regression were used to analyze the data.<p>RESULTS: Thirteen eyes(15%)with secondary glaucoma postoperative BCVA(LogMAR)were 0.63±0.20. And 73 eyes(85%)without secondary glaucoma postoperative BCVA were 0.44±0.27, there was statistically significant difference in BCVA between the two groups(<i>t</i>=2.417, <i>P</i><0.05). Glaucoma occurred in 29%, 18% and 3% of patients with cataract extraction ≤3mo, 3-12mo and >12mo, respectively. Fisher analysis there was statistically significant difference between operation age ≤3mo and >12mo(<i>P</i><0.05). The difference of axial length(AL)and refraction diopter between with and without secondary glaucoma were statistically significant(<i>t</i>=-2.92, <i>P</i>=0.004). Multivariate Logistic regression analysis showed surgery age ≤12mo was the risk factor(<i>OR</i>=8.372, 95%<i>CI</i>: 1.033-67.864, <i>P</i>=0.047). Cataract surgery age below 12mo is 8.372 times the probability of secondary glaucoma than surgery age above 12mo.<p>CONCLUSION: Most children can achieve good postoperative visual acuity and the secondary glaucoma occurred after surgery. The age of cataract surgery more than 12mo is a risk factor for postoperative secondary glaucoma, especially cataract surgery age below 3mo is much higher the probability of secondary glaucoma than above 12mo. Patients with secondary glaucoma have longer AL, smaller refraction diopter and more pronounced myopia drift than patients without secondary glaucoma.

Application of 23G vitrectomy system in pediatric congenital cataract surgery / 国际眼科杂志(Guoji Yanke Zazhi)

@#AIM: To investigate the therapeutic effect of 23G vitrectomy system used in children with congenital cataracts.<p>METHODS: From November 2017 to December 2018, 11 children(19 eyes)aged 3-8 years old with congenital cataract were recruited in the Department of Ophthalmology, the First Affiliated Hospital of Hainan Medical University. 23G vitrectomy instruments were used to enter the anterior chamber through the incision at the corneal limbus, and complete ring resection of anterior capsule, cataract aspiration, intraocular lens implantation, and ring resection of posterior capsule combined with anterior vitrectomy. The visual acuity, intraocular pressure and ocular conditions of the children were observed during 3-24mo of follow-up.<p>RESULTS: All the surgeries were uneventful. During the surgeries, the anterior chambers were stable, the ring resections of lens capsules were accurate, and the IOLs were implanted at the 1^st phase. The postoperative visual acuity was significantly improved compared with that before surgery. Only 1 patient had intraocular pressure higher than 25mmHg after surgery, which was controlled within the normal range after medication was given. During the follow-up period, all the children had clear corneas, no anterior chamber hemorrhage, no pupil deformation, the intraocular lens was in the center and the right position, the optic axis was transparent, and no obvious complications occurred.<p>CONCLUSION: The 23G vitrectomy system is safe and effective for the surgery of congenital cataract, it can achieve little trauma, accurate lens capsule resection, little postoperative reaction and few complications.

Advances in study on mutations of congenital cataract-related lens protein genes / 国际眼科杂志(Guoji Yanke Zazhi)

@#Congenital cataract is the most common cause of visual impairment and blindness in children worldwide, with about a quarter is related to genetics. To date, more than 100 gene mutations have been found in inherited congenital cataracts. As the most important component of the crystalline lens, the gene mutation of lens protein is closely related to congenital cataract. A large number of studies have confirmed that the pathogenic genes associated with congenital cataract include α/β/γ lens protein gene, membrane protein gene, cytoskeleton protein gene, and so on. About half of the mutations occurred in the lens protein genes, and the gene mutation may affect the stability, solubility and oligopoly of the protein, as well as interfere with the orderly arrangement of lens fibers, and lead to lens opacity. In this paper, the research progress of lens protein genes related to congenital cataract in recent years is reviewed.

Research progress on genetic mutation of congenital cataract / 国际眼科杂志(Guoji Yanke Zazhi)

@#Cataract is a kind of eye disease that causes lens metabolic disorder and protein degeneration and turbidity due to various reasons. Congenital cataract is especially serious. It is a common eye disease that affects the visual development of infants. It can inhibit the development of visual pathway and cause permanent blindness. About one-third of the cases are genetically related, of which autosomal dominant inheritance is the most common genetic mode. It's occurrence and development may be related to genes involved in lens development. Up to now, hundreds of mutation sites in more than 40 genes have been found to be associated with congenital cataract. This article will review the genetic research progress of congenital cataract.

A Case Series of Hereditary Congenital Cataract

@#Congenital cataract is a major cause of preventable blindness in children. It can be either hereditary or non-hereditary. In this case series, we present three cases of congenital cataract with a strong family history. The grandparents and parents of these patients had cataract diagnosed in late childhood whilst the patients in this case series were diagnosed with congenital cataract earlier. There was no history of consanguineous marriage in any of the families. These cases show that, in the presence of a strong family history, a child will present with congenital cataract earlier in their life. Hence, babies from such families should be screened at birth and at regular intervals within the first year of life to enable early diagnosis and subsequent surgical intervention to reduce the incidence and burden of amblyopia.

Expression of miRNAs in the lens of normal infants and cataract patients at different ages / 国际眼科杂志(Guoji Yanke Zazhi)

@#AIM: To describe microRNAs(miRNAs)expression pattern in infant and cataract human lens, analyzing the possible difference to assess their function in transparent human lens and cataract formation. <p>METHODS: The different ages of miRNAs in lens were extracted and samples were divided into four groups: infant lens group(lens from non-ophthalmopathy infant), congenital cataract group(lens from cataract infant), young and middle-aged group(lens from young cataract patients)and senile group(lens from age-related cataract patients). The expression of the 10 miRNAs was detected in the four groups using stem-loop RT-PCR respectively.<p>RESULTS: In normal infant's lens, the expression of miR-184 was the highest. Compared with the normal infant's lens tissue, the miR-184 and miR-182 in congenital cataract patients increased, the miR-124 and miR-204 decreased. Compared with the children's lens with cataract, the expression of miR-204, 124 and let-7d in young and middle-aged cataract patients increased, while the expression of miR-184, 183 and let-7a decreased. In the lens of senile cataract patients, all of the 10 miRNAs changed. The expression of miR-182, 204, 124 increased, while miR-184, 181b, 183, 125b, let-7a/b/d decreased.<p>CONCLUSION: There are significant differences in the expression of miRNA in the lens of children and cataract patients of different ages. Some miRNAs are related to the normal morphology, function and certain pathological conditions of the lens. This study provided a theoretical basis of further study on the role of miRNAs in maintaining the normal function of the young children's lens and the formation of cataracts at different ages.

A clinicopathological study of persistent fetal vasculature

Purpose: To study the clinicopathological findings of Persistent Fetal Vasculature (PFV) in patients with congenital cataract and PFV. Methods: Six eyes with anterior or combined PFV with cataract underwent phacoaspiration with primary posterior capsulotomy with anterior vitrectomy with intraocular lens implantation followed by histopathological evaluation of the PFV stalk and membrane. Results: Four and two patients had combined and anterior PFV respectively. There was no postoperative hyphema, vitreous haemorrhage, glaucoma or retinal detachment in six months. Haematoxylin and eosin staining showed inflammatory cells predominantly with extramedullary hematopoeisis and vascularisation. Conclusion: We recommend IOL implantation in PFV, with early and aggressive amblyopia therapy.

A Clinico-embryological Study Of Congenital Ocular And Its Adnexal Anomalies In A Tertiary Care Hospital

Aim: This study aims at studying different congenital ocular and its adnexal anomalies over a period of twoyears in a tertiary care hospital and their association with embryological development.Materials and Methods: 75 eyes of 60 patients having congenital ocular anomalies as diagnosed byophthalmologists from June 2015 to June 2017 were included in the study. The demographic profile, perinatalhistory, associated systemic diseases were studied. The embryological development of all the anomalies hasbeen discussed in details.Results: Out of 60 patients, 35 (58.3%) were male and 25 (41.7%) were female. Bilateral involvement was seen ‘in14(23.3%). Nasolacrimal duct anomalies were found to be the most common (33.3%) followed by congenitalcataract(29.3%),coloboma of uveal tract(20.0%), microphthalmous (4.0%), anophthalmous (4.0%), persistentpupillary membrane (2.7%), congenital glaucoma(1.3%), congenital ptosis(1.3%), Heterochromia iridis (1.3%),coloboma of lids (2.7%) of total eyes. History of consanguinity was present in 13.13% and a history of maternalinfection during the antenatal period was found in 8.3%. Systemic involvement was seen in 6.06%.Conclusion: Proper knowledge of the developmental pathogenesis of congenital ocular anomalies is highlyimportant for correct diagnosis and early intervention. Preventive measures can be applied if history is takenproperly during evaluation of the patients.

Paediatric cataract surgery in Hospital Kuala Lumpur - A 5-year review of visual outcomes

@#Paediatric cataract surgery is challenging with reported post-operative visual acuity (VA) of 0.3LogMar or better varying between 33% to 68% of patients. OBJECTIVE: The aim is to document the post-operative refraction, VA and complications of non-traumatic pediatric cataract surgery performed in a tertiary referral center in Malaysia.

Application of phacoemulsification and intraocular lens implantation combined with anterior vitrectomy in treatment of children with congenital cataract / 吉林大学学报(医学版)

Objective: To analyze the curative effect of phacoemulsification and to intraocular lens implantation combined with anterior vitrectomy in the children with congenital cataract, and to investigate its effectiveness and security. Methods: A total of 43 cases (49 eyes) of 3-7 years old congenital cataract children who were admitted to our hospital were selected as the subjects. According to different treatment methods, the children were divided into control group (23 cases with 26 eyes) and treatment group (20 cases with 23 eyes). The children in control group were treated with phacoemulsification and intraocular lens implantation and the children in treatment group were treated with phacoemulsification, intraocular lens implantation and anterior vitrectomy. After operation, the vision of the children in two groups was observed; the intraocular pressure (IOP), anterior chamber depth, posterior capsule turbidity and the complications in operation and after operation of the children in two groups were detected by non-contact tonometer and ultrasonic biological microscope. Results: The children in two groups were followed up for an average of 12 months after surgery, and 49 eyes were follow-up after operation. Compared with control group, the vision of the children in treatment group was improved significantly, and the constituent ratio of the children with corrected visual acuity after opertion≥O. 5 was significantly increased (P0. 05). Conclusion: Phacoemulsification and intraocular lens implantation combined with anterior vitrectomy in the children with congenital cataract can effectively improve the visual acuity, anterior chamber depth and posterior capsule opacity; it is more helpful for the reconstruction of visual function after operation in the children.