Treatment of congenital and early childhood cataract

Behandlung der kongenitalen und frühkindlichen Katarakt

Abstract

The successful outcome of treatment for infant and childhood cataract depends on many factors. It is crucial that the treatment falls into a phase in which neither the eye nor the visual pathway and visual cortex are fully developed. This review summarizes the current state of knowledge and provides an overview of the epidemiology, causes and clinical forms, early detection and, above all, treatment options. Special attention is paid to time-critical stages of development, according to which the therapeutic concepts are based. Complications, such as amblyopia and glaucoma are discussed in detail. In addition to surgical aspects, much emphasis is placed on orthoptic-refractive aftercare, the quality and execution of which is the essential predictor of a good functional outcome.

Zusammenfassung

Der erfolgreiche Ausgang einer Behandlung der Linsentrübung im Säuglings- und Kindesalter hängt von vielen Faktoren ab. Von Bedeutung ist, dass die Therapie in eine Phase fällt, in der weder das Auge, noch die Sehbahn und der visuelle Kortex ausgereift sind. Diese Übersichtsarbeit fasst den aktuellen Wissenstand zusammen und gibt einen Überblick über die Epidemiologie, die Ursachen und klinischen Formen, die Früherkennung und v. a. die Therapieoptionen. Besonderes Augenmerk wird dabei auf die Beachtung zeitkritischer Entwicklungsstufen gerichtet, nach denen sich die Therapiekonzepte richten. Komplikationen wie Amblyopie oder das Glaukom werden ausführlich diskutiert. Neben operativen Aspekten wird viel Gewicht auf die orthoptisch-refraktive Nachsorge gelegt, deren Qualität und Ausführung der wesentliche Prädiktor für ein gutes funktionelles Ergebnis sind.

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Acknowledgements

The author would like to thank his colleagues Prof. Judith Fischer, Prof. Claudia Kuhli-Hattenbach, Dr. Terese Neuhann, and Prof. Ute Spiekerkötter, as well as the orthoptists Ute Gilles, Heike Link, and Carolin Wolf for their critical review of the manuscript and helpful suggestions and additions.

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Correspondence to Prof. Dr. Wolf A. Lagrèze.

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Authors

W.A. Lagrèze; A. Financial interests: Research funding: BMBF, DFG. Speaker fees or reimbursement of expenses: Boehringer Ingelheim, Santhera, med update, Alcon. Paid advisor/internal training reference/salary recipient or similar activities: Boehringer Ingelheim, InfectoPharm. B. Non-financial interests: Official University Professor, University Hospital Freiburg, Department of Ophthalmology. Memberships: DOG, BVA, EUNOS, ARVO, Bielschowsky Society.

For this article no studies with human participants or animals were performed by any of the authors. All studies mentioned were in accordance with the ethical standards indicated in each case.

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Lagrèze, W.A. Treatment of congenital and early childhood cataract. Ophthalmologe (2021). https://doi.org/10.1007/s00347-021-01370-z

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Keywords

  • Infant
  • Child
  • Lens
  • Amblyopia
  • Glaucoma

Schlüsselwörter

  • Säugling
  • Kind
  • Linse
  • Amblyopie
  • Glaukom