Treatment of congenital cataract is:
A i.e. Needling & aspiration Surgical techniques employed for removal of paediatric (congenital or developmental) cataract include - lens aspirationQ, lens aspiration with anterior vitrectomy, lensectomy ( limbal or pars plana route), and extracapsular cataract extraction (ECCE) preferrably by phacoemulsificationQ. Presently the technique of intracapsular cataract extraction (ICCE), discission (needling) and linear extraction (curette evacuation) are obsolete procedures and sparingly performed world wide. Surgery in pediatric patients involve anterior capsulorrhexis, aspiration of lens matter, capsulorrhexis of posterior capsule, limited anterior vitrectomy, and IOL implantationQ, if appropriate. Method Advantage Disadvantage Indication Lens Limbal route + either single Can implant IOL in Theoretical risk of Preferred method aspiration incision or two po bimanual bag and manoeuvre astigmatism & when intraocular technique + 5mm anterior capsulorrhexis with poorly dilated pupil endothelial loss lens implanted Q Lens Limbal route + 5mm anterior Reduces chances of Risk of cystoid Preferred method in aspiration and 4 mm planned posterior posterior capsular macular oedema infants less than 2 with anterior vitrectomy capsulorrhexis + anterior vitrectomy opacification years Lensectomy Limbal or Pars plana route. The No posterior - Incarceration of the In neonates & lens is completely eaten away capsular vitreous in the infants less than 2 with a vitrectomy instrument + opacification scleral incision years of age but is peripheral rim of capsule for - Risk of retinal not preferred by secondary lens implanation is left by some surgeon. detachment some surgeons - Surgery hindered if pupil constricted
Needing and aspiration
Intracapsular extraction
Extracapsular extraction
Cryotherapy