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CATARACT Outcome of early surgery for bilateral congenital cataracts in eyes with microcornea. Nishina S, Noda E, Azuma N. Am J Ophthalmol. 2007 Aug;144(2):276-280. Epub 2007 May 29. PURPOSE: To report the outcome of early surgery for bilateral congenital cataracts in eyes with microcornea. METHODS: We retrospectively reviewed 22 eyes of 11 patients with microcorneas who underwent early surgery for bilateral congenital cataracts. All patients underwent lensectomy and anterior vitrectomy via the limbal approach by 12 weeks of age. The corneal diameters at the time of surgery ranged from 7.0 to 9.0 mm. The mean age at the time of surgery was 7.7 +/- 3.3 weeks (range, two to 12 weeks); the follow-up period was 115 +/- 58 months (range, 40 to 199 months). Aphakic eyes were corrected with spectacles or contact lenses. Visual acuities and the postoperative complications were evaluated periodically. RESULTS: The morphologic types of cataract were nuclear (12 eyes), complete (eight eyes), and membranous (two eyes). Other preoperative ocular abnormalities included iris hypoplasia in 10 eyes and persistent fetal vasculature in three eyes. Systemic abnormalities were found in four patients. Postoperative complications occurred in 11 eyes (50%), including glaucoma (nine eyes), exudative retinal detachment (two eyes), rhegmatogenous retinal detachment, and secondary membrane formation, in one eye each. The binocular visual acuity was 20/40 to 20/20 in six patients (55%), 20/200 to 20/100 in two patients (18%), and 2/100 or worse in three patients (27%) who developed postoperative glaucoma. CONCLUSION: Despite microcorneas, favorable visual outcomes were achieved after early surgery in this series. However, adequate management of postoperative complications, especially glaucoma, is required. Central corneal thickness: Congenital cataracts and aphakia. Muir KW, Duncan L, Enyedi LB, Wallace DK, Freedman SF. Am J Ophthalmol. 2007 Aug 13; [Epub ahead of print] PURPOSE: To evaluate central corneal thickness (CCT) in normal children (controls) and in those with cataracts, pseudophakia, and aphakia. METHODS: CCT was measured in 369 eyes of 223 children. Subjects with glaucoma, anterior segment abnormalities, or intraocular pressure of more than 30 mm Hg were excluded. Group means were compared for controls and for eyes with pediatric cataracts, pseudophakia, and aphakia. RESULTS: The mean CCT of eyes with cataracts was more than that of controls (574 +/- 54 mum [n = 46] and 552 +/- 38 mum [n = 230], respectively; P = .001). After 24
excluding from the cataract group those eyes with aniridia, Down syndrome, Marfan syndrome, or glaucoma surgery, the mean CCT (564 +/- 34 mum [n = 36]) was no longer greater than that of controls (P = .07). The mean CCT of pseudophakic eyes (598 +/- 56 mum [n = 29]) was greater than the mean CCT of controls (P < .001) and was similar to the mean CCT of eyes with cataracts (P = .06). The mean CCT of aphakic eyes (642 +/- 88 mum [n = 64]) was greater than the mean CCT of controls (P < .001), eyes with cataracts (P < .001), and eyes with pseudophakia (P = .003). CONCLUSIONS: In the absence of factors known to affect CCT (Down syndrome, Marfan syndrome, and aniridia), CCT is similar in eyes with pediatric cataracts and normal controls and increases after cataract surgery. Pediatric cataract extraction with intraocular lens implantation: Visual acuity outcome when measured at age 4 years and older. Ledoux DM, Trivedi RH, et al. J AAPOS 2007; 11: 218-24. The authors present 139 eyes gleamed from charts of 510 consecutive pediatric patients undergoing cataract extraction which meant the exclusion criteria for conditions such as tramatic cataract, secondary IOL implantation, ROP, severe developmental delay, and less than four years of age at last follow-up. The median acuity of all eyes was 20/30, with the bilateral cases being slightly better than the unilateral cases (20/25 to 20/40 respectively). They also found that older age at time of surgery and more normal interocular length measurements were associated with better visual acuity. Amblyopia was the major cause of residual visual deficit. 19 of 139 eyes have final visual acuity worse than 20/200. Changes in interocular axial length after pediatric cataract surgery. Trivedi RH, Wilson Jr ME. J AAPOS 2007; 11: 225-29. The authors retrospectively looked at the pre-and postoperative axial links of 47 eyes receiving pediatric cataract surgery and intraocular lens implantation. They found that eyes with a shorter axial length than the fellow eye showed an accelerated rate of postoperative gross compared to eyes with a longer interocular axial length. Eyes with a longer axial length than the fellow eye showed a slower rate of axial growth postoperatively. The growth rates showed a trend of postoperative intraocular axial length differences to move towards zero. 25
Page 1 and 2: What’s New and Important in Pedia
Page 3 and 4: ROP Retinopathy of Prematurity: the
Page 5 and 6: same diagnosis in 4 of 34 images (1
Page 7 and 8: PREMATURITY Perinatal care in the t
Page 9 and 10: STRABISMUS Causes and outcomes for
Page 11 and 12: METHODS: The medical records of all
Page 13 and 14: initial positive response to medica
Page 15 and 16: deviation as an intermittent exodev
Page 17 and 18: STRABISMUS SURGERY Unilateral reces
Page 19 and 20: The effect of topical tetracaine ey
Page 21 and 22: +/-0.08 and 0.34 +/-0.07 mm, for th
Page 23: THYROID Cigarette smoking and thyro
Page 27 and 28: Long-Term Results of Lensectomy in
Page 29 and 30: CATARACT SURGERY Pediatric anterior
Page 31 and 32: Suture-related complications after
Page 33 and 34: included vitrectomy, capsulotomy, c
Page 35 and 36: medication. At the last follow-up,
Page 37 and 38: REFRACTIVE ERROR / REFRACTIVE SURGE
Page 39 and 40: demonstrated a positive effect on t
Page 41 and 42: ANTERIOR SEGMENT Conjunctival Melan
Page 43 and 44: RESULTS: Directly after birth, corn
Page 45 and 46: and photophobia (80%). The children
Page 47 and 48: Validity and reliability of the Chi
Page 49 and 50: outcomes achieved at cessation of t
Page 51 and 52: METHODS: One hundred and thirteen c
Page 53 and 54: Verisyse intraocular lens implantat
Page 55 and 56: GENETICS Marfan syndrome: from mole
Page 57 and 58: Visual outcome of a cohort of child
Page 59 and 60: primarily affect the photoreceptors
Page 61 and 62: single morphogenetic anomaly in dev
Page 63 and 64: Three genome-wide association studi
Page 65 and 66: • Cafe-au-lait macules • Freckl
Page 67 and 68: Laryngeal and tracheal anomalies Po
Page 69 and 70: Treatment of retinoblastoma: Curren
Page 71 and 72: Secondary acute myeloid leukemia af
Page 73 and 74: one. Patients treated with radiatio
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Neuro-ophthalmological management o
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CONCLUSION: Canalicular involvement
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peripheral retinal vasculitis. The
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This article describes a 7-month-ol
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eference eyes. Photopic flash ERGs
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RESULTS: In models that adjusted fo
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ORBIT Porous orbital implants, wrap
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PLASTICS Conjunctival epithelial ch
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The authors conclude that lash ptos
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.03). SBP and DBP were significantl
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CONGENITAL INFECTION Congenital lym
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PEDIATRICS Visual Manifestations of
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controversial, ranging from one to
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SYSTEMIC Visual function and ocular
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Toxocara infection. Toxocara GWC an
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congenital cataracts. The retina wa
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Childhood blindness: a UK epidemiol
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safe and efficient procedure to cor
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