What's New in Pediatric Ophthalmology

American Academy of Ophthalmology 2013

Evelyn Paysse, MD


December 12, 2013

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Pediatric Cataract

Hello. I'm Dr. Evelyn Paysse, Attending Physician at Texas Children's Hospital and Professor of Ophthalmology and Pediatrics at Baylor College of Medicine in Houston. Welcome to Medscape Ophthalmology Insights. I'm here at the American Academy of Ophthalmology Meeting in New Orleans and wanted to share some of the highlights in pediatric ophthalmology from this year's meeting.

At the pediatric subspecialty day, many different topics were covered.

First, I would like to talk about the management of pediatric cataract. Many different tips were given throughout the session.

Ed Wilson[1] discussed removal of difficult cortex. He suggested using a small incision and to use hydrodissection with caution, because many types of pediatric cataracts have weak posterior capsule. He also suggested removing the peripheral cortex first, because the posterior capsule in children becomes convex, and in this way you can avoid rupture of the capsule. He further advocates the use of iris hooks and rings, because the iris often will not dilate very well in pediatric cataracts.

Jan de Faber[2] discussed the pediatric Artisan® (Ophtec; Groningen, The Netherlands) aphakic intraocular lens. He has used this lens for about 25 years in The Netherlands. He uses this lens for primary subluxated lenses, secondary intraocular lenses when there is poor residual capsular support, and in patients who are phakic with high myopia when contact lenses are intolerant. He feels that these are better than scleral sutured lenses because they hold less risk. There is no risk for suture breakage. However, they are contraindicated when there is a shallow anterior chamber or there is weak iris support. He also states that there is a steep learning curve for this technique, but that it can be done, and it's an excellent treatment for aphakia in children.


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