Evaluation of Lens Opacity: Do I Operate or Not? Why?

Abstract

The decision whether or not to operate on an infant with a partial cataract is based on the morphology of the lens opacity. Indications of a visually significant opacity include an opacity larger than 3 mm., a posterior cataract, a cataract which is confluent without clear intermediate zones. The ability to visualize retinal detail with a direct ophthalmoscope is also important. In verbal children a visual acuity of 20/70 or worse is usually the guideline for surgery. In some cases, children will present with cataracts which may have been present since early infancy, or even birth. In these patients who present late with presumed congenital cataracts, the question whether to operate or not is often difficult. Signs of a good prognosis include lamellar cataracts, posterior lenticonus, persistent hyperplastic primary vitreous (anterior type), and patients with unilateral cataracts and straight eyes with no strabismus. Even patients with nystagmus may show improvement.

• infantile cataracts
• surgery
• surgical indications