The Management of Posterior Polar Cataract: The Role of Patching and Grading

Abstract

Background: The milder form of posterior polar cataract is often discovered late in preschool children if secondary symptoms like strabismus are not present. The question addressed in this paper is: do such children still profit from orthoptic and surgical treatment? Patients and methods: This was a retrospective study of the data from 13 patients, median age 4 years (range: 1 month to 12 years), with a mean follow-up of 4 years. Four changes to the red reflex were introduced. Results: Surgery followed from two weeks to three years after starting occlusion therapy. Before therapy, the best visual acuity was 0.3 and the worst 0.06 (median 0.16). A median of four years after starting therapy, the visual acuity ranged from 0.9 to 0.4 (median 0.6). Conclusion: All milder cases profited from the treatment despite its late start. An earlier discovery would improve the prognosis. In any case, however, ophthalmologists should be encouraged to try patching before resorting to surgery.

KEYWORDS:

• Cataract surgery
• occlusion therapy
• posterior polar cataract
• visual acuity
• pediatric ophthalmology