Abstract:Uso pré-operatório de biomicroscopia ultrassônica em catarata pediátricaDear Editor: I read the article "Epilens membrane simulating cataract in children with uveitis: a report of three cases" by Paiva et al. with great interest (1) . Three cases were presented that were diagnosed as cataract secondary to uveitis but that were understood to have received treatment for pupillary membrane intraoperatively. I congratulate the authors for their attention and good management.Cataract surgery is a radical operation … Show more
“…Epilens membrane may simulate cataract in paediatric uveitic eyes despite a clear lens 33 . Preoperative UBM can assess for the presence of any cataract, 34 and the surgeon should take care to avoid anterior capsule breach during the release of the pupillary membrane and synechiolysis if the lens is clear.…”
Ultrasound biomicroscopy (UBM) is an invaluable investigation for imaging anterior segment structures. Although it is operator‐dependent and time consuming, unlike optical‐based imaging techniques, it is able to image structures posterior to the iris, such as the zonules, ciliary body and part of the pars plana. It is especially useful in advanced cataracts, traumatic cataracts, subluxed lenses, posterior polar cataracts, and congenital and developmental anomalies affecting the anterior segment. It provides diagnostic information in eyes with complex cataracts or intraocular lens (IOL)‐related pathology, and aids in surgical planning in order to minimise complications. In this review, we describe the UBM features of various lenticular pathologies and demonstrate its application in the diagnosis and surgical management of lens and IOL‐related pathologies.
“…Epilens membrane may simulate cataract in paediatric uveitic eyes despite a clear lens 33 . Preoperative UBM can assess for the presence of any cataract, 34 and the surgeon should take care to avoid anterior capsule breach during the release of the pupillary membrane and synechiolysis if the lens is clear.…”
Ultrasound biomicroscopy (UBM) is an invaluable investigation for imaging anterior segment structures. Although it is operator‐dependent and time consuming, unlike optical‐based imaging techniques, it is able to image structures posterior to the iris, such as the zonules, ciliary body and part of the pars plana. It is especially useful in advanced cataracts, traumatic cataracts, subluxed lenses, posterior polar cataracts, and congenital and developmental anomalies affecting the anterior segment. It provides diagnostic information in eyes with complex cataracts or intraocular lens (IOL)‐related pathology, and aids in surgical planning in order to minimise complications. In this review, we describe the UBM features of various lenticular pathologies and demonstrate its application in the diagnosis and surgical management of lens and IOL‐related pathologies.
“…The preexisting posterior capsular defect presents as a total cataract or sometimes a differential opacity (more white at the center than in the periphery), white dots on posterior capsule or anterior vitreous, and a fish-tail sign. [ 31 ] The diagnosis can be confirmed on ultrasound biomicroscopy[ 33 ] [ Fig. 3 ].…”
Section: Etiologymentioning
confidence: 99%
“…USG helps us rule out retinal detachment, fundal coloboma, and retinoblastoma. [ 33 ] USG in a case of unilateral cataract can diagnose a PFV. [ 50 ] Magnetic resonance imaging can be ordered if there is a high degree of suspicion of PFV which is missed on USG.…”
Pediatric cataract is a leading cause of childhood blindness. Untreated cataracts in children lead to tremendous social, economical, and emotional burden to the child, family, and society. Blindness related to pediatric cataract can be treated with early identification and appropriate management. Most cases are diagnosed on routine screening whereas some may be diagnosed after the parents have noticed leukocoria or strabismus. Etiology of pediatric cataract is varied and diagnosis of specific etiology aids in prognostication and effective management. Pediatric cataract surgery has evolved over years, and with improving knowledge of myopic shift and axial length growth, outcomes of these patients have become more predictable. Favorable outcomes depend not only on effective surgery, but also on meticulous postoperative care and visual rehabilitation. Hence, it is the combined effort of parents, surgeons, anesthesiologists, pediatricians, and optometrists that can make all the difference.
“…Anterior segment examination of the LE with fully dilated pupil showed total cataractous lens with invisible posterior capsular details (figure 1A). Ultrasound biomicroscopy (UBM) of the LE showed a large posterior capsular defect with subluxation of the lens into the vitreous cavity1 beyond the capsule (figure 1B). Care was taken to avoid lens drop during irrigation–aspiration.…”
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