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PubMed1999

Management of coincident corneal disease and cataract.

The status of the cornea is crucial to a good outcome with cataract extraction. Preexisting corneal disease must be managed appropriately to get the high-quality results that we have come to expect with cataract surgery. It is now more common to perform cataract surgery on patients with previous corneal refractive surgery, and in these patients intraocular-lens power calculation is more challenging. Complications following cataract surgery and intraocular-lens implantation that involve the cornea are uncommon because of advances in surgical techniques. Corneal complications can include mechanical or toxic injury of the endothelium, stripped Descemet's membrane, epithelial toxicity and disruption, infectious keratitis, and epithelial ingrowth. Endothelial-cell survival after cataract extraction and lens implantation is still the major concern. Healing of the cornea following clear corneal incisions has become more important, as this technique is more frequently used. Patients with ocular surface disease still require extra lubrication and management of blepharitis to prevent epithelial toxicity at the time of surgery as well as postoperatively. Clear corneal cataract extraction and lens implantation causes minimal disruption of the conjunctiva, allowing cataract surgery to be performed in patients with severe ocular surface disease such as ocular cicatricial pemphigoid. Overall, modern-day cataract extraction is very safe for the cornea.

Cataract↗
PubMed2006

Long-term follow-up of the corneal endothelium after artisan lens implantation for unilateral traumatic and unilateral congenital cataract in children: two case series.

PURPOSE: To retrospectively estimate the long-term corneal endothelial cell loss in children after perforating corneal trauma and implantation of an iris-fixated anterior-chamber intraocular lens (IOL), either the Artisan aphakia lens or the Artificial Iris Implant, and to compare this corneal endothelial cell loss to that in children who received an Artisan aphakia lens to correct aphakia after cataract extraction for unilateral congenital cataract. METHODS: A retrospective study was performed, evaluating the charts and endothelial photographs of 6 patients with unilateral traumatic cataract, with a mean age at IOL implantation of 9.5 years (range: 5.8-12.8 years) and a mean follow-up after IOL implantation of 10.5 years (range: 8.0-14.7 years), and of 3 children who were operated on for unilateral congenital cataract at a mean age of 2.7 years and who received an Artisan aphakia IOL, with a mean follow-up after IOL implantation of 9.5 years (range: 4.7-14.5 years). Parameters that were studied were central endothelial cell density (CECD) in both the operated and the normal eye at the last follow-up visit, percentage of cell loss in the operated eye compared with the normal eye, and length and location of the corneal scar in the injured eye. RESULTS: : In the traumatic cataract group, CECD was, on average, 41% (range: 22%-58%) lower in the operated eye (1.647 +/- 322 [SD] cells/mm) than the normal eye (2.799 +/- 133 cells/mm). A significant negative linear correlation was found between the length of the corneal perforation scar and CECD. In the congenital cataract group, no statistical difference in CECD was found between the operated (3.323 +/- 410 cells/mm) and the unoperated (3.165 +/- 205 cells/mm) eye. CONCLUSION: Endothelial cell loss 10.5 years after iris-fixated IOL implantation for traumatic cataract was substantial and related to the length of the corneal scar of the original trauma. In children operated on for congenital cataract, no difference was found in CECD in the operated and unoperated eyes 9.5 years after Artisan aphakia IOL implantation.

Anterior Chamber↗
PubMed2004

Comparison of preoperative conjunctival bacterial flora in patients undergoing glaucoma or cataract surgery.

PURPOSE: To assess differences in conjunctival bacterial flora between patients undergoing glaucoma and cataract surgery. PATIENTS AND METHODS: A prospective study comparing conjunctival bacterial cultures obtained from 339 patients undergoing either cataract (n = 258) or glaucoma (n = 81) surgery. All cultures were acquired during the preoperative visit, approximately three to seven days prior to surgery. The culture samples were inoculated onto blood and chocolate agar, as well as blood culture broth media. All bacterial isolates were identified and statistical analyses were performed to determine if there were differences in flora between the eyes undergoing cataract versus glaucoma surgery. RESULTS: Two hundred fifteen of 258 eyes (83%) undergoing cataract surgery were found to have positive bacterial growth, compared with 62 of 81 eyes (77%) of those undergoing glaucoma surgery (P = 0.2246). Coagulase-negative Staphylococci, the most common bacterial isolate, was cultured from 167 eyes (65%) in the cataract group and 42 (52%) in the glaucoma group (P = 0.0514). Among all bacterial isolates, only Corynebacterium species was found to be statistically different between the two patient groups with 92 (36%) and 11 (14%) eyes testing positive in the cataract and glaucoma groups, respectively (P = 0.0003). CONCLUSIONS: There was no statistically significant difference in the proportion of conjunctival culture samples testing positive for bacterial growth in eyes undergoing glaucoma surgery compared with those undergoing cataract surgery. Glaucoma medications, or their preservatives, do not appear to significantly alter conjunctival flora. Techniques used for endophthalmitis prophylaxis prior to cataract surgery are likely appropriate for glaucoma surgery as well.

Bacteria↗
PubMed2026

Integrative multi-omics quantitative trait loci prioritize CASP7 as a candidate protective gene for cataract.

Cataracts are the leading cause of vision loss worldwide. Despite surgery being the only effective treatment, its economic burden highlights the necessity of exploring the pathogenesis of cataracts. In this study, we analyzed 4 large-scale GWAS (genome-wide association study) datasets for cataracts and performed SMR analysis along with heterogeneity in dependent instruments (HEIDI) testing to explore the effects of methylation, expression, and protein QTLs on cataracts. We further validated shared genetic variants through COLOC analysis. Additionally, we searched datasets related to cataracts from the Gene Expression Omnibus (GEO) database for differentially expressed genes (DEGs) and Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes pathway (KEGG) enrichment analyses. By integrating summary-based Mendelian randomization (SMR) results with bioinformatics findings, CASP7 showed a consistent protective-direction association with cataract risk (mQTL: OR [95% CI] = 0.959 [0.941-0.977], FDR-adjusted P = .039; eQTL: OR [95% CI] = 0.897 [0.860-0.937], FDR-adjusted P = .0046; pQTL: OR [95% CI] = 0.597 [0.483-0.738], FDR-adjusted P = .00083). GEO-based analyses provided transcriptomic support for CASP7 involvement in cataract-related lens biology. These findings prioritize CASP7 as a genetically supported candidate protective gene associated with cataract risk. Because this study is based on public summary-level and transcriptomic datasets, the results should be interpreted cautiously and require functional validation in human lens-relevant systems.

Quantitative Trait Loci↗
PubMed1977

Causes of enucleation following cataract surgery.

Between the years 1962 and 1976 85 eyes which had undergone cataract surgery were accessioned to the Ophthalmic Pathology Laboratory of the Helsinki University Eye Hospital. The specimens were submitted from the various eye departments of the country. Of these 8k eyes nine had been enucleated within 2 months after surgery while in 64 cases the enucleation had been performed more than 12 months after surgery. 40 eyes had had an attempted operation for senile cataract, 30 eyes for traumatic cataract while the remaining cases were congenital cataract cases or cataracts in pre-existing glaucomatous or chronic uveitis eyes. Most frequent causes for the loss of the eyes were related to incomplete or abnormal healing of the operative wound such as epithelial down-growth and closure of the chamber angle with extensive anterior synechiae leading to absolute glaucoma. It is noteworthy that all cases of epithelial downgrowth were derived from the beginning of the observation period. No new cases were obtained after 1969. Other important causes were purulent endophthalmitis and retinal detachment. Haemosiderosis was a prominent cause in the group with traumatic cataract. A careful histopathological analysis of eyes enucleated after cataract surgery is mandatory as it is from the complications we learn most in cataract surgery.

Aged↗
PubMed2006

Influence of cataract on optical coherence tomography image quality and retinal thickness.

BACKGROUND: As optical coherence tomography (OCT) is widely used for diagnosis and monitoring of ocular pathology, especially in the elderly people, the influence of cataract on image quality and macular retinal thickness was studied. METHODS: In 29 patients scheduled for cataract surgery, preoperative and postoperative OCT scans were obtained. Cataracts were categorised as nuclear, posterior or cortical. Parameters for image quality (signal-to-noise ratio (SNR)) and signal strength and macular thickness were compared. A three-level expert grading scale was used to evaluate the discriminative abilities of SNR and signal strength. RESULTS: Nuclear cataracts (n = 12) provided better preoperative scans (higher SNR/signal strength) than posterior (n = 7) and cortical (n = 10) cataracts (p<0.004). Postoperatively SNR and signal strength increased significantly in all patients (p<0.001). The SNR was better at discriminating poor from acceptable and good scans than signal strength (area under the receiver operating curve: 0.879 and 0.810, respectively). Postoperative macular thickness overall showed a significant increase (p = 0.005), most evident in patients with posterior cataracts (p = 0.028). CONCLUSIONS: OCT imaging is influenced by cataract; image quality is reduced preoperatively and macular thickness measurements are slightly increased postoperatively. In individual patients, OCT scans remain reliable for gross clinical interpretation, even in the presence of cataract.

Aged↗
PubMed2006

Prevalence of blindness and cataract surgery in Gandaki Zone, Nepal.

BACKGROUND/AIM: Himalaya Eye Hospital (HEH), established in 1993, is rendering eye care services in the Gandaki and Dhaulagiri zones. The hospital has extensive community outreach activities along with services for outpatients, emergencies, and subspecialties such as vitreoretinal, paediatric, and low vision. The operation theatre is well equipped to match the surgical needs including phaco surgery for cataract. The hospital has performed more than 14 000 cataract surgeries and 250 000 treatment services during this period. The aim of this study was to estimate the prevalence of blindness, visual impairment, and cataract surgical coverage among the older adult population of three districts of Gandaki Zone, where 80% of the hospital's service recipients reside. METHODS: People aged 45 years and older were enrolled in the study using a stratified cluster design. Subjects in 25 randomly selected clusters from the listed 806 were recruited through door to door visits. Each recruited subject had visual acuity (VA) and clinical examination conducted by an ophthalmologist. The survey was preceded by pre-pilot and pilot studies to refine the operational method. To assess quality assurance the interobserver variation in VA measurement was also carried out in five different clusters. RESULTS: Out of 5863 selected subjects 85.3% were examined. Blindness defined as presenting VA <6/60 in both eyes was found in 2.6% (95% confidence interval (CI): 2.2 to 3.9), whereas 16.8% individuals examined had vision <6/19 in one or both eyes. Cataract was the principal cause of blindness in 60.5%, and refractive error was the dominant cause of vision impairment (<6/19) 83.3%. Cataract surgical coverage was 59.5% among the cataract blind and associated with younger age, literacy, and male sex. CONCLUSION: The finding suggests a positive impact of the HEH programme on the prevalence of blindness and cataract surgical services in the survey area. Strategies to further improve access and utilisation of facilities and increase cataract surgical coverage need to be developed.

Age Factors↗
PubMed2007

Pulsed electron avalanche knife: new technology for cataract surgery.

BACKGROUND: The pulsed electron avalanche knife (PEAK-fc) is a new pulsed electrosurgical device that allows for precise, "cold" and traction-free tissue dissection. AIM: To evaluate the surgical applicability, safety and potential complications of PEAK-fc in complicated cataract surgery. METHODS: The study included five children with congenital cataracts, two patients with advanced senile cataracts, six adults with mature cataracts, three of them with posterior iris synechia, three patients with post-traumatic cataracts with zonulolysis, one patient with intumescent traumatic cataract and three patients with massive anterior capsule opacification. Anterior and posterior capsulotomies, iris synechiolysis, dissection of anterior capsule opacification and fibrotic scar tissue were performed. PEAK-fc was set at voltages of 500-700 V, pulse duration of 0.1 m and repetition rate of 40-100 Hz. RESULTS: Anterior and posterior capsulotomies were successfully and safely performed in all eyes. The edges of capsulotomies appeared sharp, showing only limited collateral damage. PEAK-fc worked best by just gently touching the capsule, thereby avoiding tractional forces or pressure on the lens capsule. Posterior iris synechiae could be released and anterior capsule opacification was dissected without complications. CONCLUSIONS: PEAK-fc is a very helpful cutting device for complicated cases of cataract surgery, especially for mature and congenital cataracts, traumatic zonulolysis or anterior segment complications after intraocular inflammation.

Adolescent↗
PubMed1996

Monitoring and evaluating cataract intervention in India.

AIM: To identify indicators to monitor and evaluate the cataract intervention programme in India. METHODS: Available data on blindness due to cataract, demography, staffing levels, and infrastructure available under the programme were reviewed. Four key elements of the programme were identified: the magnitude of blindness due to cataract and the need for surgical services; the available resources; the output, in quantity and in quality, as well as the resource utilisation; and lastly the impact this has on society and the problem of blindness due to cataract. Indicators to quantify these key elements were designed and available data were used to calculate the defined indicators. RESULTS: At least 2.5 million sight restoring cataract operations will have to be performed annually. Staffing levels and infrastructure resources at present allow for increased output. The effectiveness of cataract services can be increased with better case selection. CONCLUSION: The use of these indicators provides an insight into the dynamics of the problem of cataract blindness and its intervention. They facilitate adequate management and evaluation of the efficiency and effectiveness of the intervention programme and may ensure optimal utilisation of the available resources for cataract surgery.

Blindness↗
PubMed2001

Daily tonometric curves after cataract surgery.

AIM: To evaluate daily tonometric curves after cataract surgery in patients with cataract only and in patients with cataract and glaucoma. METHODS: 108 patients scheduled for cataract surgery were randomly allocated to two groups: 57 patients with cataract only (normal) and 51 with cataract and primary open angle glaucoma (POAG). All patients underwent extracapsular cataract extraction (ECCE) (manual technique with long wound), phacoemulsification (automated technique with short wound), or nucleus capture (manual technique with short wound). Intraocular pressure (IOP) was measured by Goldmann tonometry in all patients every 2 hours for 12 hours before the operation and at 1 and 6 months postoperatively. RESULTS: 79 patients completed the 6 month examination. ECCE resulted in greater reductions in IOP than the other procedures (ECCE: 27% and 36% in normal patients and those with POAG, respectively; nucleus capture: 20% and 31%, respectively; phacoemulsification: 19% and 22%, respectively). The fluctuations in IOP before and after surgery were not statistically significant. CONCLUSION: Cataract surgery in normal patients reduces IOP but does not eliminate fluctuations which are directly proportional to the IOP value and result partly from circadian rhythms. This important finding might influence our approach to treatment of patients with glaucoma.

Aged↗
PubMed2002

Cataract surgery and quality of life in patients with age related macular degeneration.

BACKGROUND: The coexistence of cataract and age related macular degeneration (AMD) is not unusual, especially in the very elderly. The outcome of cataract surgery in these cases depends on the effect of AMD on vision. In this study the authors have compared the outcome of cataract patients with AMD to that of cataract patients with no vision threatening ocular comorbidity, and analysed possible predictors of good or poor outcome. METHODS: An observational prospective study on consecutive cases operated for cataract during 1 month at six surgical departments affiliated to the Swedish National Cataract Register (NCR). Data were collected according to the protocol of NCR and subjects completed the Catquest questionnaire before and 6 months after surgery. 90 subjects with AMD were compared to 335 subjects with no sight threatening ocular comorbidity. RESULTS: Difficulties in performing various daily life activities improved significantly for AMD subjects after surgery (p<0.001, Wilcoxon signed rank test). Satisfaction with vision also improved significantly after surgery (p<0.001, Wilcoxon signed rank test). Activity level and independence were unchanged. Subjects with no ocular comorbidity had a still better outcome. The most important variable related to a good self assessed functional outcome was postoperative visual acuity irrespective of the presence of AMD. AMD subjects scheduled for second eye surgery and AMD subjects dissatisfied with their vision before surgery had a poorer outcome. CONCLUSION: Subjects with various stages of dry AMD and cataract improved their self assessed visual function and satisfaction with vision significantly after cataract extraction.

Activities of Daily Living↗
PubMed2002

Changes in visual acuity from 4 to 12 years of age in children operated for bilateral congenital cataracts.

AIMS: To investigate the long term effects of age at surgery on the development of visual acuity (VA) by measuring VA from preschool age to puberty. Furthermore, to report the VA levels at 12 years of age in a geographically based cohort of operated congenital bilateral cataracts. METHODS: All children born in four western counties of Sweden between January 1980 and December 1993 who were diagnosed with congenital cataracts were included in a longitudinal prospective study. The monocular VA of the better eye in 38 subjects was analysed at 4, 7, 10, and 12 years of age, with 20 total and 18 partial cataracts. The mean follow up time was 9.3 years after surgery. RESULTS: The final value of VA was 0.4 or above for approximately 50% of the subjects at 12 years of age. Visual acuity improved to a considerable extent after school age, especially in children who underwent surgery between the ages of 7 weeks and 1 year. Results for partial cataracts were favourable compared to those for total cataracts, reaching a mean of approximately 0.5 at age 12. The mean VA in the group of total congenital cataracts operated on before 7 weeks of age achieved higher values of VA at 4 years of age compared to children with total cataracts operated on between 7 weeks and 1 year of age. However, no statistically significant difference in VA results among these groups could be proved. CONCLUSION: Visual acuity improves to a considerable extent after school age in children with delayed visual development caused by congenital cataracts. Surgery within 7 weeks results in a more rapid development of VA, initially.

Age Factors↗
PubMed2002

VF-14 item specific responses in patients undergoing first eye cataract surgery: can the length of the VF-14 be reduced?

AIMS: To report the item specific responses of the VF-14 in a population of patients undergoing cataract surgery in their first eye and to determine whether or not the VF-14 can be reduced without compromising its performance as an index of cataract related visual impairment. METHODS: The item specific responses to the VF-14 were analysed before (771 patients) and 4 months after (552 patients) cataract surgery in one eye to determine if the VF-14 index can be reduced without compromising its performance. Patients studied were selected from a cross sectional longitudinal study of patients undergoing cataract surgery in 72 ophthalmologist's offices located in three metropolitan regions of the United States. RESULTS: Pairwise correlations between items in the VF-14 were all less than 0.6, indicating that no items could be removed solely on the basis of redundancy. 10 items correlated moderately with change in trouble, and 11 correlated moderately with change in satisfaction (r >0.15) at 4 months after cataract extraction. Eleven items demonstrated an effect size >0.4 at 4 months. These 11 items were either important for detecting cataract related functional disability or for quantifying the extent to which cataract impaired function. Additionally, 11 items were needed to detect adequately individuals with functional impairment. Three items (recognising people, cooking, and reading large print) were less responsive to cataract extraction and were more strongly associated with ocular comorbidities. CONCLUSIONS: While previous reports indicate that the VF-14 can be significantly shortened, our analysis only justifies removing three items. While the resulting VF-11 has properties similar to the VF-14, the limited time savings do not justify altering this already validated instrument.

Aged↗
PubMed2002

Frequency of ciliary body or retinal breaks and retinal detachment in eyes with atopic cataract.

AIM: To determine the frequency of ciliary body or retinal breaks and retinal detachment in eyes with atopic cataract. METHODS: The records of 106 eyes (74 patients) with atopic cataract that underwent cataract extraction were reviewed. The frequency of ciliary body or retinal breaks and retinal detachment was classified by their presence preoperatively and postoperatively, and by cataract type. RESULTS: Breaks were detected preoperatively in 27 eyes (25.5%) of 17 patients in the ciliary body (20 eyes, 18.9%), near the ora serrata (five eyes, 4.7%), and in undefined locations (two eyes, 1.9%). Among these, 16 eyes (15.1%) had already developed retinal detachment. After surgery, a ciliary body break occurred in one eye (0.9%) and retinal detachment in four eyes (3.8%) of three patients. The breaks that caused postoperative retinal detachment were in the ciliary body. When classified by cataract type, the highest frequency of breaks was associated with mature cataracts (35.0%), and all eyes with breaks developed retinal detachment. CONCLUSIONS: One fourth of eyes with atopic cataract had breaks in the ciliary body or ora serrata, or retinal detachment preoperatively. The highest frequency of either breaks or retinal detachment was associated with mature cataract. The frequency of breaks or detachment that occurred postoperatively (approximately 5%) was lower than that present preoperatively.

Adolescent↗
PubMed1992

Nutrient intake and cataract extraction in women: a prospective study.

OBJECTIVE: To examine prospectively the association between dietary intake of vitamins C and E, carotene, and riboflavin and cataract extraction in women. DESIGN: Prospective cohort study beginning in 1980 with eight years of follow up. SETTING: 11 states of the United States. PARTICIPANTS: Female registered nurses who were 45 to 67 years of age. 50,828 women were included in 1980 and others were added as they became 45 years of age. MAIN OUTCOME MEASURE: Incidence of extraction of senile cataracts. RESULTS: 493 cataracts were extracted during 470,302 person years of follow up. Intake of carotene and vitamin A was inversely associated with cataract: in multivariate analyses, women in the highest fifth of total vitamin A intake (excluding supplements) had a 39% lower risk of cataract relative to women in the lowest fifth (relative risk 0.61; 95% confidence interval 0.45 to 0.81). Neither riboflavin nor dietary vitamins E or C were associated with cataract in a multivariate analysis. Among specific food items spinach (rather than carrots, the greatest source of beta carotene) was most consistently associated with a lower relative risk. The risk of cataract was 45% lower among women who used vitamin C supplements for 10 or more years(relative risk 0.55 (0.32 to 0.96)), but no association was noted for multivitamin intake. CONCLUSION: Dietary carotenoids, although not necessarily beta carotene, and long term vitamin C supplementation may decrease the risk of cataracts severe enough to require extraction.

Aged↗
PubMed2005

Perceptions of patients about cataract.

OBJECTIVE: To identify in adult patients suffering from cataract the perceptions regarding the disease and its surgical treatment. MATERIALS AND METHODS: An exploratory survey was conducted among adult patients suffering from cataract and participating in a large-scale cataract management program at the University of São Paulo General Hospital in 2004. The interviews were conducted by research assistants previously trained to pose questions and record answers. RESULTS: The sample consisted of 170 men and women (43.5% and 56.5%, respectively), aged between 40 and 88 years. Of the 170 participants, 43.5% were from the State of São Paulo, 14.7% from the State of Bahia, 12.4% from the State of Minas Gerais, 5.9% from the State of Pernambuco, 1.8% from other countries, and the remaining 21.7% were from other Brazilian states. Of those who were actively working (n = 87), 43.7% had an occupational level corresponding to nonspecialized manual labor, 27.6% were in specialized manual labor jobs, 25.3% had routine nonmanual occupations, 1.1% supervised manual labor, and 2.3% had low-ranking supervision or inspection jobs over nonmanual occupations. Of those who were not actively working (n = 82), 53.6% were retired, 45.2% were housewives, and 1.2% were unemployed. Concerning conceptions about cataract, 79.0% referred to it as "a small skin fold that gradually covers the eye" and 32.4% mentioned, in addition, other conceptions. Concerning the cause, of the alternatives presented to them, 80% reported aging, 47.1% blamed "overusing the eyes in the workplace or at home", 7.1% believed they had cataract due to some kind of "spell." Of the associated answers, 94.1% referred to "blurred vision" in people suffering from cataract, 72.4% thought the person may become blind, and 66.5% believed that the patients suffering from cataract are depressed because they cannot see. Regarding surgery, 28.8% were afraid of undergoing surgery; of those, 16.3% cited with the fear of dying during surgery, 55.1% thought they might become blind, 40.8% believed the surgery would be painful, and 8.2% followed religious practices that do not permit surgery. CONCLUSION: Some misconceptions were identified, and the fear of blindness was the most mentioned reason for not seeking cataract surgery, which indicates the need for orientation.

Adult↗
PubMed1985

Aging-related cataract: laboratory investigation and clinical management.

Cataract disrupts the crystalline lens, a transparent, elastic, avascular, biconvex structure composed of a capsule, lens epithelium, and lens fiber cells. Many factors contribute to the progression of lens opacity, but aging is most frequently associated with cataract. As aging-related cataract develops, many biochemical and biophysical changes occur, most notably a marked increase in the insolubilization of the crystallin and extensive oxidation damage to many of the lens constituents. Cataract management should include ophthalmologic history and examination, medical evaluation, optical correction, control of ocular and systemic disease that may contribute to cataract, discontinuation of cataractogenic drugs, and periodic reexamination. Surgery is indicated when cataract is associated with vision decrease interfering with activities important to the patient, intraocular inflammation or glaucoma, or interference with management of posterior segment disease. More than 600 000 cataract operations are done in the United States each year; in 1982 an estimated 496 000 cataract operations were combined with intraocular lens implantation.

Aged↗
PubMed1997

[Study on the effect of different disease courses on pre- and post-operative visual acuity in cases with congenital cataract].

OBJECTIVE: To study the effect of different disease courses on the visual acuity of congenital cataracts. METHOD: 876 cases with five kinds of human congenital cataract have been studied. RESULTS: It has been found that the preoperative visual acuity (VA) is closely related to the length of disease course. The longer the course of disease, the worse the VA. When the disease courses were shorter than one year, the most serious reduction of preoperative VA was found in the patients with congenital total cataract. When the disease courses were within one to four years, the most remarkable reduction of VA was found in patients with congenital dense nuclear cataract (CDNC). When the disease courses were longer than four years, except the congenital anterior polar cataract, the VA in all the other four kinds of cataracts were decreased significantly. It is indicated that the postoperative VA highly depends on the preoperative VA. In the group with disease courses shorter than one year, this relationship is the most remarkable. Some kinds of congenital cataract showed accelerated changes in preoperative VA, especially in the CDNC. CONCLUSION: It is suggested that the key point to get better visual function in cases with congenital cataract should be to discover and treat the patients as early as possible.

Adolescent↗