Best treatment for cataracts in children?

Although unusual, children are sometimes born with cataracts or develop them shortly after birth. When a cataract is removed, a lens implant needs to be inserted in its place. The timing of when to insert the lens implant has been controversial.

Researchers examined results from 220 eyes of 148 patients who underwent pediatric cataract surgery to determine whether there was a difference in visual acuity in patients who received posterior chamber lens implant implantation at the time of the surgery (primary implantation) versus having the lens implant performed at a later time (secondary implantation).

Primary posterior implantation was performed in 180 eyes and secondary implantation was performed in 40 eyes with a mean age of 6.84 years in the primary implantation patients and 8.92 years in the secondary implantation patients.

When visual acuity was checked at follow-up, the primary IOL group has a mean best corrected visual acuity of 0.44 vs. 0.28 in the secondary IOL group. Patients in the primary implant group developed strabismus (crossed eyes) at a lower rate than the secondary IOL group.

In summary, inserting a lens implant during the cataract surgery rather than afterwards resulted in better vision and fewer complications.

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