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Nucci P (ed): Pediatric Cataract. Dev Ophthalmol. Basel, Karger, 2016, vol 57, pp 85–106 (DOI: 10.1159/000442505)

Complex Cases in Pediatric Cataract Preeti Patil-Chhablani a Ramesh Kekunnaya a Kanwal Ken Nischal b a

L V Prasad Eye Institute, Hyderabad, India; b Children’s Hospital of Pittsburgh of UPMC, Pittsburgh, Pa., USA

Abstract This chapter describes the techniques and pitfalls that the reader may come across when dealing with complex pediatric cataract cases. Each eye in these circumstances is unique, and the examples and general advice shared are intended to help the reader develop a plan for surgery and a road map to avoid potential problems. As in all types of surgery, careful planning is essential. The old saying ‘Fail to prepare, then you prepare to fail’ is no more true than when dealing with children who have complex cataract. In this chapter, the following circumstances where pediatric cataract may be seen are discussed: retinoblastoma, retinopathy of prematurity, lenticonus, congenital rubella syndrome, trauma, microcornea, pediatric uveitis, Hallermann-Streiff syndrome, Stickler syndrome, Lowe syndrome, subluxated lens, and after previous intraocular surgery (glaucoma, keratoplasty). © 2016 S. Karger AG, Basel

Children with retinoblastoma may develop cataracts as sequelae of the management of the primary disease by external beam radiotherapy. Cataracts may also be a manifestation of the primary disease processes itself [1, 2]. Surgical management is indicated not only for visual rehabilitation but also to improve visualization of the tumor and to aid further monitoring and treatment. Cataract surgery is challenging in patients with retinoblastoma due to several factors. Since tumor recurrence may be seen after intraocular surgery, tumor quiescence must be ensured before planning cataract surgery. The improvement in visual acuity is not dependent upon cataract surgery alone and is influenced by the extent of retinal/macular involvement and amblyopia.

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Retinoblastoma


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