Innovations in pediatric cataract surgery

Khokhar, Sudarshan; Pillay, Ganesh; Agarwal, Esha; Mahabir, Manish

doi:10.4103/ijo.ijo_860_16

Cited by 31 publications

(15 citation statements)

References 81 publications

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“…Congenital cataract is still the leading cause of vision loss and blindness in children 8. Children's disability with the lens opacification reaches 9.4%–37.3%, leading to social disadaptation and a decrease in life quality.…”

Section: Discussionmentioning

confidence: 99%

Effect of pterygopalatine blockade on perioperative stress and inflammatory outcomes following paediatric cataract surgery

Oleshchenko

Çok

Юрьева

et al. 2020

Reg Anesth Pain Med

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BackgroundGeneral anesthesia is required to perform pediatric cataract surgery. To reduce severity of surgical intervention and postoperative complications, regional techniques have been concomitantly used. The traditional regional ophthalmic techniques are retrobulbar, peribulbar and sub-Tenon blocks, which present some technical difficulties and associated complication risks. The pterygopalatine blockade has been exempt of many of these concerns as it is performed out of the orbit. The purpose of this study was to compare the analgesic and anti-inflammatory effects of the pterygopalatine blockade with retrobulbar block in children undergoing elective congenital cataract surgery.MethodsAfter approval of ethics committee and informed consents, patients were enrolled to the study to have either ultrasound-guided pterygopalatine block (group P) or retrobulbar block (group R), with 2 mL lidocaine 2% and 1 mL ropivacaine 0.5%. Hemodynamic monitoring was recorded throughout the perioperative period. Cortisol level and oxidation–reduction status were assessed before and after surgery. Pain and inflammatory response (Tyndall effect, corneal syndrome and edema) were assessed on the first postoperative day.ResultsComparative analysis demonstrated a decrease in cortisol of 123.24% (p˂0.05) and an increase in the redox coefficient of 37.7% (p˂0.05) in group P. Pain intensity was significantly higher in group R until the 16th postoperative hour. The corneal syndrome in patients in group P and group R was noted by 7.6% and in 32.1%, respectively (p˂0.05).ConclusionThe use of the pterygopalatine blockade as a component of anesthesia in pediatric cataract surgery allows reduction of the severity of surgical stress during surgical intervention, providing intraoperative hemodynamic stability and prolonged analgesia.

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Section: Discussionmentioning

confidence: 99%

Effect of pterygopalatine blockade on perioperative stress and inflammatory outcomes following paediatric cataract surgery

Oleshchenko

Çok

Юрьева

et al. 2020

Reg Anesth Pain Med

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“…In children, hydrophobic IOLs are considered better than PMMA IOLs in terms of greater biocompatibility and smaller incision size, with late onset and lower rate of PCO formation. 6,7 Intraoperative challenges in paediatric cataract surgery are running off capsulorhexis due to elasticity of the capsule, positive intravitreal pressure, intraoperative miosis and wound leak. These complications have significantly reduced using closed chamber surgical technique.…”

Section: Discussionmentioning

confidence: 99%

Paediatric cataract

Kapoor¹,

Prabu²,

Udayakumar³

2018

AOVS

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“…IOL implantation has become the most accepted mode of refractive correction after cataract extraction in children older than 1 year of age [9][10][11][12]. This has been possible because of advances in IOL surgery that include availability of high viscosity viscoelastics [13] improved IOL design [14] and posterior scleral beveled incision [15] that significantly reduces the incidence of complications that were encountered with the early attempts at IOL implantation in children. Autrata [16] et al reported better visual outcomes in children who had undergone IOL implantation than in those managed with contact lens.…”

Section: Discussionmentioning

confidence: 99%

Results of secondary ciliary sulcus fixated posterior chamber intra-ocular lenses in paediatric aphakia

Faruqui¹,

Khan²,

Jain³

2017

Trop J Ophthalmol Otolaryngol

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Introduction: Primary Intraocular lens implantation is the most preferred method of paediatric cataract management. However there is little literature on secondary correction of aphakia with IOL implantation. Objective: The objective of this study was to evaluate the safety and efficacy of ciliary sulcus implantation of posterior chamber IOLs in cases of paediatric aphakia. Materials and Methods: The charts of 33 patients (52 eyes) ranging from 2-15 years of age, who underwent secondary implantation of PCIOL in the ciliary sulcus between 2016-17 were studied. Those cases that had sufficient capsular support after primary cataract extraction were included. Demographic data was obtained and correlated with the final outcomes in terms of refractive error, post op complications and visual outcome. Results: The final mean visual acuity in log MAR was 0.64±0.42. 43% of eyes showed good visual acuity 0.4-0.6 log MAR. After surgery 85% patients with amblyopia showed good visual good response to occlusion therapy. Patients with aphakia operated for traumatic cataract achieved better visual acuity than those with congenital cataract (0.31±0.36 and 0.64±0.42 respectively). Mean difference of -0.06D was observed between targeted refraction and actual refraction. Conclusions: Patients who had early primary cataract surgery showed better final visual acuity. Our observed complication rate showed that this method of aphakia correction is safe and effective.

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Innovations in pediatric cataract surgery

Cited by 31 publications

References 81 publications

Effect of pterygopalatine blockade on perioperative stress and inflammatory outcomes following paediatric cataract surgery

Effect of pterygopalatine blockade on perioperative stress and inflammatory outcomes following paediatric cataract surgery

Paediatric cataract

Results of secondary ciliary sulcus fixated posterior chamber intra-ocular lenses in paediatric aphakia

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