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Lena Dixit, Michael Puente, Kimberly Yen; Characteristics of Anterior Polar Cataracts in Children. Invest. Ophthalmol. Vis. Sci. 2015;56(7 ):2183.
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To evaluate pediatric patients with unilateral or bilateral anterior polar cataracts and assess the development of astigmatism, rate of amblyopia, change in visual acuity, and need for surgery over time.
A retrospective chart review was performed on patients examined at Texas Children’s Hospital in Houston, Texas from 2008 to 2014. Patients with unilateral or bilateral anterior polar cataracts (APCs) were included in the study. Patients with mixed etiology cataracts or other causes of poor visual acuity were excluded. Size, location, and type of anterior polar cataract were assessed. Best corrected visual acuity and refraction were recorded from the initial visit and subsequent encounters. Development of amblyopia, anisometropia, and astigmatism were recorded. Size and type of cataract were correlated with the development of each outcome. Statistical analysis was performed on each categorical variable with significance set at p < 0.05.
A total of 31 patients were included in the study. 17 patients had unilateral APCs and 14 had bilateral APCs. 83% were centrally located and 17% were non-central. 40% of patients had concurrent ocular conditions and 10% had systemic associations. 21% of patients with bilateral cataracts developed amblyopia compared to 35% in the unilateral population. 29% of patients with bilateral cataracts had anisometropia compared to 24% in the unilateral population. 3 patients required surgical intervention.
Most anterior polar cataracts are less than 1 mm in size and of the polar type. Risk of amblyopia is higher than the general population. Anisometropia is the most common cause of amblyopia. Ocular and systemic associations can occur but are uncommon. Surgical treatment is uncommon; however, growth of APCs, pyramidal type, and associated cortical changes may be risk factors for surgery.
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