Untersuchungsmethodik zur Diagnostik der ein- und beidseitigen kindlichen Katarakt

Today, the management of congenital and developmental pediatric uni- and bilateral cataract is still a problem, particularly because untreated lens opacity has a high amblyogenic potential. Such irreversible deprivation amblyopia in pediatric cataracts requires an early diagnosis. Due to the increased inflammatory reaction postoperatively, a minimally traumatic operation, intensive occlusion therapy and optimal correction with glasses or contact lenses are also necessary. Uni- and bilateral cataracts and their preoperative diagnostics have to be considered separately.     

Neues zur Amblyopietherapie

In recent years there has been a lively discussion on the benefits of early detection and treatment of amblyopia, as well as large prospective randomized controlled studies. Furthermore, we now have the opportunity to measure effective occlusion time. This leads to a better scientific base for discussion of amblyopia therapy.     

Die kindliche Katarakt – eine interdisziplinäre Herausforderung

Cataract in childhood is threatening because of its irreversible amblyogenic potential. Deprivation amblyopia is discussed in its` neuropathological basics and current therapeutical methods such as lentectomy, correction of aphakia and postoperative optic rehabilitation are introduced. Early diagnostic methods and basics of optic rehabilitation being of importance for pediatricians are specially pointed out.     

Astigmatismus nach transskleraler Hinterkammerlinsenimplantation bei Kleinkindern

BACKGROUND: The purpose of this study was to evaluate the postoperative astigmatism after trans-scleral fixation of intraocular lenses in children and to develop a strategy for amblyopia prophylaxis. PATIENTS AND METHODS: In eight eyes with lentectomy, posterior chamber intraocular lenses were fixed in the ciliary sulcus by trans-scleral sutures. The postoperative astigmatism was measured by retinoscopy every 1 to 2 weeks in the first 2 months, followed by monthly intervals thereafter. Keratometry was performed with an automated hand keratometer. RESULTS: Postoperative astigmatism was 2.5 to 8.0 D. The astigmatism regressed to 0.75 D in half the eyes within 4 weeks and in five of the eyes within 16 weeks. In one of the eight eyes, the astigmatism decreased to 2.0 D and in two it remained unchanged. The astigmatism did not change any more after 16 weeks postoperatively. Visual acuity was 0.016 to 1.0. CONCLUSIONS: Our study shows that the postoperative astigmatism regresses soon and does not seriously interfere with amblyopia therapy. If greater than 2 D, half of the astigmatism should be corrected with glasses, even in the early postoperative period. After 16 weeks, full correction is recommended.