Konjenital kataraktlarda cerrahi tedavi endikasyonları ve optik rehabilitasyon

Konjenital kataraktlar çocukluk çağındaki körlüklerin önemli bir kısmını oluşturur. Çocukluk çağı körlük nedenleri arasında en sık görülen tedavi edilebilir hastalıktır. Asıl tedavisi cerrahidir. Cerrahinin zamanlaması ve cerrahi sonrası hızlı ve uygun görsel rehabilitasyon prognozu büyük ölçüde etkilemektedir. Tanı konduktan sonra mümkün olan en kısa sürede cerrahi yapılması ambliyopi gelişimini önlemek için gereklidir. Konjenital kataraktın görsel rehabilitasyonu optik düzeltme ve ambliyopi tedavisini içermektedir. Ambliyopinin en etkili tedavisi kapama tedavisidir. Bu makalede, konjenital kataraktlar son literatürler ışığında değerlendirildi, cerrahinin zamanlaması ve görsel rehabilitasyonun önemi vurgulandı.

The indication of surgical treatment and visual rehabilitation in the congenital cataracts

Congenital cataracts constitute an important part of blindness in childhood. It's a curable disease which is one of the most common causes of blindness in childhood. Main treatment is surgical operation. Timing of surgery, appropriate and rapid post surgery visual rehabilitation have a major effect on prognosis. Surgery should be performed as soon as possible after the diagnosis in order to prevent amblyopia. Visual rehabilitation of congenital cataract includes optical correction and amblyopia treatment. The most effective treatment of amblyopia is occlusion therapy. In this article congenital cataracts were evaluated in the light of recent literature and the importance of the timing of surgery and visual rehabilitation were attempted to be emphasized.

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  • 1.Monte AM. Diagnosis and management of congenital and developmental cataracts. Opht.Clin of North America.1990; 3: 205-19.
  • 2.Bardelli AM, Lasorella G, Vanni M. Congenital and developmental cataracts and multiformation syndromses. Ophthalmic Pediatr. Genet. 1989; 10: 293-8.
  • 3.Potter WS. Pediatric cataracts. Pediatr.Clin North Am. 1993; 40: 841-53.
  • 4.Wilson FM. Pediatric ophthalmology and strabismus. California:American Academy of Ophthalmology. 1990; 75-83.
  • 5.Robinson DH. Pediatric Ophthalmology. W.B.Saunders Company. Philadelphia. 1983.
  • 6.Gilbert CE, Canovas R, Hagan M, Roa S, Foster A. Causes of childhood blindness: Result from West Africa, South İndia, and Chile(Abstr) Eye. 1993; 7: 184-8.
  • 7. Warburg M, Emery AE, Rimoin DL. Congenital blindress, Principles and practice of medical genetics. Churchill Livingstone.1990; 631-6.
  • 8.Bekaroğlu Y, Çıngıl G. Körler okulu öğrencilerinde körlük nedenlerinin incelenmesi 20. Ulusal Türk Oftalmoloji Kongresi Bülteni. Uludağ Üniversitesi Basımevi. Bursa.1986; 527-31.
  • 9.Temel A , Coşkuncan N , Kozakoğlu H. İstanbul-Kilyos körler okulundaki körlük nedenlerinin dağılımı. XX. Ulusal Türk Oftalmoloji Kongresi Bülteni. Ankara. 1990;20: 364-7.
  • 10.Lorraine C, Jugnoo R, Ken N, Isebelle R, David T. Outcome of lens aspiration and intraocular lens implantation in children aged 5 years and under. British Journal of Ophthalmology. 2001; 85: 540-2.
  • 11.Bradford GM, Keech RV, and Scott W.E. Factors affecting visual outcome after surgery for bilateral congenital cataracts. Am.J.Ophthalmol.1994; 117: 58-64.
  • 12.Grossman SA, Peyman GA. Long-term visual results after pars plicata lensectomyvitrectomy for congenital cataracts. Br.J.Ophthalmol. 1998; 72: 601-6.
  • 13.Keech RV, Tongue AC, Scott WE. Complications after surgery for congenital and infantile cataracts. Am.J.Ophthalmol.1989; 108: 136-41.
  • 14.Hubel DH, Wiesel TN. Period of susceptibility to the physiological effects of unila- teral eye closure in kittens. J.Physiol.1970; 206: 419-36.
  • 15.Parks MM. Management of the posterior capsule in congenital cataracts. J.Pediatric Ophthalmol and Strabis.1984; 21: 115-7.
  • 16.Gelbart SS, Hoyt CS, Jastrebski G, Marge E. Longterm visual results in bilateral congenital cataracts.1982; 93: 615-22.
  • 17.Guo S, Nelson LB, Colhoun J. Simultanes surgery for bilateral congenital cataracts. J.Pediatric Opht.Strabismus.1990; 27: 23-27.
  • 18.Onur C. Konjenital kataraktlarda lensektomi ön vitrektomi zamanlaması ve iki göz ameliyatı arasında geçen sürenin görme düzeylerine etkisi. TOD. 28. Ulusal kongresi Bülteni.1994; 2: 580-2.
  • 19.Parks MM. Posterior lens capsulotomy during primary cataract surgery in children. Ophthalmology.1983; 90: 344-5.
  • 20.Parks MM, Johnson DA, Reed GW. Longterm visual results and complications in children with ophatika. A function of cataract type. Ophthalmology.1993; 100: 826-40.
  • 21.Cheng KP: Treatment of pediatric cataracts. In Stamper R.L(eds): Ophthalmology Clinics: Philadelphia, W.B Sunder Company, June 1996.
  • 22.Birch EE , Stager DR. Prevalence of good visual acuity following surgery for congenital unilateral cataract. Arch. Ophthalmol.1988; 106: 40-3.
  • 23.Cheng KP, Hiles DA, Biglan AW, Pettapiece MC. Visual results after early surgical treatment of unilateral congenital cataracts. Ophthalmology. 1991; 98(6): 903- 10.
  • 24.Baker J.D. Visual rehabilitation of aphakic children-contact lenses: Surv Ophthalmol.1990; 34: 366-71.
  • 25.Neumann D, Weissman BA, Isenberg SJ, Rosenbaum AL, Bateman JB. The effectiveness of daily wear contact lenses for the correction of infantile aphakia. Arch Ophthalmol.1993; 111: 927-30.
  • 26.Assaf AA, Wiggins R, Engelk K, Senft S: Compliance with prescribed optical correction in cases of monocular aphakia in children.Saudi J Ophthalmol. 1994; 8: 15-22.
  • 27.Markham RH, Bloom PA, Chandna A, Newcomb EH. Results of intraocular lens implantation in pediatric aphakia. Eye. 1992; 6: 493-8.
  • 28.İçağasıoğlu A, Kubaloğlu A, Güzelce T,Yılmaz ÖF. Çocukluk çağı kataraktlarında intraoküler lens implantasyonu.T Oft Gaz. 1992; 22: 145-9.
  • 29.Dahan E: Choice of lens and dioptric power in pediatric pseudophakia. J Cataract Refract Surg. 1994; 20: 607-9.
  • 30.Zwaan J: Pediatric intraocular lens implantation. Ophthalmol. 1998; 105: 112-19.
  • 31.Gimbel HV, Ferensowicz M, Ranaan M, DeLuca M: Implantation in children. J Pediatr Ophthalmol Strabismus. 1993; 30: 69- 79.
  • 32.Morgan KS. Visual rehabilitation of aphakia children: IV Epikeratophakia. Surv Ophthalmol. 1990; 34: 379-84.
  • 33.American Academy of Ophthalmology: Epikeratoplasty. Ophthalmol. 103:983-90, 1996.
  • 34. Brady KM, Atkinson CS: Cataract surgery and intraoculer lens implantation in children. Am J Ophthalmol. 1995; 120: 1-9.