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Query: UMLS:C0086543 (cataract)
 29,165 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The case reports are given of two adult patients who lost all fusion ability and had the signs and symptoms of central fusion disruption and intractable diplopia. Both patients suffered binocular sensory deprivation for several years caused by a combination of a traumatic cataract and uncorrected unilateral aphakia. One patient had a posterior chamber intraocular lens inserted to correct the aphakia and the other patient had a contact lens. Aniseikonia was not appreciated by either patient and did not appear to contribute to the fusion problem. Adjustable strabismus surgery, in both patients, and prism glasses, in one, enabled approximate superimposition of the visual axes. After several months, both patients began to develop some fusion with small amplitudes and the vertical bobbing typical of central fusion disruption disappeared.
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PMID:Fusion ability lost and regained in visual adults. 336 Mar 34

At 7 months of age, an infant with Lowe's oculocerebrorenal syndrome developed an epimacular membrane after three intraocular surgeries in the right eye. Serial fundus photographs document the membrane's appearance 6 months after lensectomy/vitrectomy for a dense cataract and 2 months after the second trabeculotomy for congenital glaucoma. Epimacular membranes are a vitreoretinal disorder found almost exclusively in adults. To the best of our knowledge, this is the first documented case of acquired preretinal macular membrane in an infant and the youngest case reported in the literature. The loss of formed vitreous and repeated deposition of blood products into the vitreous cavity may be responsible for the development of this preretinal membrane.
J Pediatr Ophthalmol Strabismus
PMID:Acquired epimacular membrane after multiple intraocular procedures in an infant. 341 24

Epikeratophakia provides a permanent optical correction for aphakia in children with congenital or traumatic cataracts; suturing the epikeratophakia graft onto the cornea eliminates the problems of contact lens or spectacle non-compliance in these young and generally uncooperative patients and provides tectonic support to scarred and irregular corneas. Eighteen children under the age of six years underwent epikeratophakia for the correction of aphakia after the removal of trauma-induced cataracts. Graft success rate was 88%; the average change in keratometry in the patients with successful grafts was 14.82 +/- 2.0 diopters. In the 13 patients eligible for visual acuity tabulation, preoperative acuities ranged from light perception to 20/200, and postoperative acuities ranged from hand motions to 20/30. Ten (77%) had acuities of 20/80 or better. Poor results in three patients with less than 20/200 acuities were likely the results of non-compliance with amblyopia therapy. Present work indicates that in cases of traumatic cataract, the epikeratophakia procedure facilitates amblyopia therapy and decreases the astigmatism in scarred and irregular corneas.
J Pediatr Ophthalmol Strabismus
PMID:Epikeratophakia in children with traumatic cataracts. 352 43

A safe effective method of global control during anterior segment surgery is presented. The method used in 1184 consecutive cases was the scleral yoke traction suture adapted from a method often used in strabismus surgery. The incidence of postoperative ptosis severe enough to require surgical correction is presented in that group as well as in a group of 591 consecutive cataract extractions utilizing the classic superior rectus traction surgery. The principle advantages of this method as compared to the classic superior rectus traction suture are pointed out, with emphasis on the reduction of postoperative ptosis.
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PMID:The scleral yoke suture for anterior segment surgery. 354 Jul 69

Three infants, one who was two weeks old, and two who were two months old, underwent lensectomy and vitrectomy in a total of four eyes for congenital cataracts by means of an automated suction cutter. Two patients with unilateral opacities underwent combined cataract extraction and epikeratophakia, and one with bilateral congenital cataracts underwent cataract extractions and was fit with extended wear contact lenses. In all cases, the surgery involved at least a 5-mm posterior capsulotomy with a shallow anterior vitrectomy, and was uneventful. Three of the four eyes developed new opacities that required surgical removal three to five months after the original surgery. Cytological evaluation of the specimen obtained from one patient showed this material to be lens epithelium. In all three cases, the material grew without the support of the posterior capsule; in one patient the material appeared to have seeded onto the iris. This previously unreported complication in infants with congenital cataracts who have undergone posterior capsulotomy and anterior vitrectomy emphasizes the need for frequent retinoscopies on such patients. The absence of the posterior capsule does not guarantee that these children will not develop secondary growth of lens epithelium which may obstruct the visual axis.
J Pediatr Ophthalmol Strabismus
PMID:Secondary cataracts in infants after lensectomies. 355 53

Despite recent advances in surgical technique and refractive correction, amblyopia remains a significant problem in the treatment of monocular infantile cataracts. Amblyopia therapy recommended by different authors during the preverbal period has varied from no patching to nearly full-time occlusion of the phakic eye. We measured preferential looking (PL) acuities sequentially in four infants following monocular cataract surgery and contact lens correction. This information was used to adjust occlusion of the phakic eye, which was prescribed 25%-100% of waking hours. Patching schedules were altered, on average, every three to four months in response to changes in PL acuities. Four increases in patching intensity retarded acuity development in the phakic and benefited development in the aphakic eyes. Nine decreases enhanced progress or yielded no change in the phakic and, with two exceptions, impeded progress in the aphakic eyes. Recognition acuities now available for two of the children show continuity with previous PL acuities and confirm useful vision in the aphakic eyes. We describe guidelines for adjusting occlusion based on our experience. We believe that PL modulation of patching therapy may result in more favorable visual outcomes for both eyes of infants with monocular cataracts.
J Pediatr Ophthalmol Strabismus
PMID:Preferential looking as a guide for amblyopia therapy in monocular infantile cataracts. 358 52

We reviewed the records of 38 consecutive patients who had persistent binocular diplopia after cataract surgery. The patients were divided into ten categories based on the suspected conditions underlying the diplopia. Of 16 patients who underwent strabismus surgery, five achieved the therapeutic goal of single binocular vision in the primary and reading position, and four attained this with prismatic or botulinum toxin therapy in addition to surgery. Seven patients continued to have diplopia despite strabismus surgery and adjunctive therapy. Even small residual deviations were often intolerable, because of highly diminished fusional amplitudes.
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PMID:Persistent binocular diplopia after cataract surgery. 359 71

To determine causative factors of persistent strabismus presenting after cataract surgery, the surgical techniques and subsequent motility findings of eight patients who had persistent postoperative strabismus were studied. In two of the eight patients, complications related to the placement of the bridle suture were believed causative based on subsequent surgical findings. A similar etiology could be speculated in an additional three patients. An isolated vascular accident coincident to the cataract operation could account for a sixth case. The final two patients were believed to have a decompensated congenital fourth nerve palsy. In no patients could the myotoxic effect of a local anesthetic or the hypoxic effect of an ocular pressure-reduction device plausibly account for the deviation.
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PMID:Persistent strabismus presenting after cataract surgery. 360 64

Twelve infants with unilateral congenital cataracts treated at Boston Children's Hospital between 1978 and 1986 have now reached the age of 3.5 years or older. All infants had cataract extractions, aphakic contact lens fitting, and occlusion of the unaffected eye by 6 months of age. Patients with posterior lenticonus or persistent hyperplastic primary vitreous were excluded from this review. Early improvement of visual acuity in the aphakic eye was monitored by preferential looking tests, and occlusion of the sound eye was adjusted accordingly. E card visual acuities are now available on all 12 children. Five patients have 20/70 or better visual acuity, three patients have between 20/100 and 20/400 vision, and four patients have less than 20/400 in the aphakic eye. Two patients whose cataract surgery was done after 4 months of age had the poorest visual results. Difficulty maintaining occlusion therapy and interruptions of contact lens wear limited the development of better vision in some patients. The visual results to date in these 12 patients suggest that early aggressive treatment of unilateral congenital cataracts is worthy of consideration in most instances.
J Pediatr Ophthalmol Strabismus
PMID:Results of early treatment of unilateral congenital cataracts. 366 65

Three children between the ages of 4 and 6 years had untreated monocular traumatic cataracts, for several years. Although amblyopia did not develop, there was a disruption of fusion that resulted in horror fusionis after cataract surgery. Two adults with strabismus and amblyopia since childhood developed cataracts as adults. The occlusion caused by these long-standing cataracts appeared to eliminate suppression and resulted in horror fusionis.
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PMID:Abnormal sensory findings secondary to monocular cataracts in children and strabismic adults. 375 1


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