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S. Guo, A.C. Tutela, A. Prasad, A.R. Caputo, R.S. Wagner; Surgical Results of Posterior Lenticonus Associated with Cataracts in Children . Invest. Ophthalmol. Vis. Sci. 2003;44(13):188.
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Purpose: To evaluate the surgical results in a series of pediatric patients with posterior lenticonus associated with cataracts using novel surgical techniques. Methods: We reviewed the clinical records of 37 pediatric patients who underwent cataract surgery. We included 7 consecutive patients (10 eyes) who had posterior lenticonus associated with cataracts and underwent cataract extraction and intraocular lens implantation with a special surgical technique at the Newark Eye and Ear Infirmary at Columbus Hospital and University of Medicine and Dentistry of New Jersey (UMDNJ) between 1998 and 2002. All eyes included in this study had a posterior lenticonus associated with a visually significant cataract confirmed by slit-lamp biomicroscopy. The patients with other ocular abnormalities were excluded from this study. All patients underwent cataract extraction with intraocular lens implantation as described in another paper. Briefly, our special surgical techniques include performing multiple, peripheral strokes of hydrodissection; cleaning of the peripheral portion of the cataract first; and converting the posterior capsular defect to a primary posterior capsulorrhexis when needed. Postoperatively, patients were scheduled for follow up after 1 week, 4 weeks, 6 months, 1 year and yearly thereafter. Results: No surgical or postoperative complications were encountered. The age at which patients underwent the surgery ranged from 4 to13 years old (mean was 9 years). Preoperative visual acuity ranged from 20/60 to counting fingers. Postoperatively, at one week, visual acuity ranged from 20/25 to 20/60. At one month all patients achieved postoperative acuities in the 20/20 to 20/40. At 6 months 83% had a visual acuity of 20/30 or better and 16% had a visual acuity of 20/40. At one year, all eyes had a visual acuity in the 20/20 to 20/30 range. Conclusion: Current surgical approaches of managing posterior lenticonus associated with cataract are fraught with high risk of complications of premature rupture of capsular defects and vitreous prolapse and/or traction. Our novel surgical techniques allow better and easier removal of the cataract in these patients and enable us to achieve consistent and excellent surgical results.
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