Management of Cataracts in Pediatric Patients with Developmental Delay at a Tertiary Care Pediatric Hospital  

作　　者：Sugi Panneerselvam Madhuri Chilakapati Alexis Moisiuc Kimberly G. Yen Sugi Panneerselvam;Madhuri Chilakapati;Alexis Moisiuc;Kimberly G. Yen(Department of Ophthalmology, Baylor College of Medicine, Houston, TX, USA;Department of Ophthalmology and Pediatrics, Texas Children’s Hospital, Houston, TX, USA)

机构地区：[1]Department of Ophthalmology, Baylor College of Medicine, Houston, TX, USA [2]Department of Ophthalmology and Pediatrics, Texas Children’s Hospital, Houston, TX, USA

出　　处：《Open Journal of Ophthalmology》2021年第2期152-162,共11页眼科学期刊（英文）

摘　　要：<strong>Background:</strong> Childhood cataract causing visual impairment can compound developmental delay (DD) if left untreated. Current literature in children with DD is limited;thus, we evaluated cataract etiology, challenges, and treatment compliance in this group. <strong>Purpose:</strong> To report the presentation and challenges associated with cataract management in children with developmental delay (DD) at a tertiary care pediatric hospital. <strong>Methods:</strong> Retrospective review of 100 patients (173 eyes) presenting with cataracts and DD from February 2014 to December 2017. <strong>Results:</strong> 100 patients (173 eyes) were included. 27 patients had unilateral cataracts and 73 bilateral. The average age was 120.55 months (SD 63.77, range 5.87 - 243.16);the average follow-up period was 57.7 months (SD 139.14, range 1.03 - 1412.30). 61% of patients (55% eyes) underwent medical management for cataracts due to: cataract was not visually significant (66% eyes), parent deferred surgery (11% eyes), self-abusive behavior (14% eyes), and medical conditions that limited visual recovery (9% eyes). 32% of patients were unable to perform objective visual acuity by age 5. Patients with self-abusive behavior were more likely to present with or develop retinal detachment (RD) (35%) compared to those without self-abusive behavior (6%) (p = 0.0028). A statistically significant difference in the difficulty of examination (p < 0.0001) and poor compliance of glasses wear (p < 0.0001) was found in nonverbal patients. Surgical complications occurred in 39% of eyes. Those with intraocular lens placement after cataract extraction were more likely to develop visual axis opacification (27% eyes) than those who remained aphakic (9% eyes) (p = 0.0313). <strong>Conclusion:</strong> Cataract extraction in pediatric patients with DD can be associated with success, however, providers should prepare for limitations in managing these patients.<strong>Background:</strong> Childhood cataract causing visual impairment can compound developmental delay (DD) if left untreated. Current literature in children with DD is limited;thus, we evaluated cataract etiology, challenges, and treatment compliance in this group. <strong>Purpose:</strong> To report the presentation and challenges associated with cataract management in children with developmental delay (DD) at a tertiary care pediatric hospital. <strong>Methods:</strong> Retrospective review of 100 patients (173 eyes) presenting with cataracts and DD from February 2014 to December 2017. <strong>Results:</strong> 100 patients (173 eyes) were included. 27 patients had unilateral cataracts and 73 bilateral. The average age was 120.55 months (SD 63.77, range 5.87 - 243.16);the average follow-up period was 57.7 months (SD 139.14, range 1.03 - 1412.30). 61% of patients (55% eyes) underwent medical management for cataracts due to: cataract was not visually significant (66% eyes), parent deferred surgery (11% eyes), self-abusive behavior (14% eyes), and medical conditions that limited visual recovery (9% eyes). 32% of patients were unable to perform objective visual acuity by age 5. Patients with self-abusive behavior were more likely to present with or develop retinal detachment (RD) (35%) compared to those without self-abusive behavior (6%) (p = 0.0028). A statistically significant difference in the difficulty of examination (p < 0.0001) and poor compliance of glasses wear (p < 0.0001) was found in nonverbal patients. Surgical complications occurred in 39% of eyes. Those with intraocular lens placement after cataract extraction were more likely to develop visual axis opacification (27% eyes) than those who remained aphakic (9% eyes) (p = 0.0313). <strong>Conclusion:</strong> Cataract extraction in pediatric patients with DD can be associated with success, however, providers should prepare for limitations in managing these patients.

关 键 词：Cataract Surgery Developmental Delay Pediatric Cataract Intraocular Lens 

分 类 号：R73[医药卫生—肿瘤]