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Phacoemulsification followed by placement of a toric intraocular lens in a child with bilateral lamellar cataract
First Author: M. Lima Fontes PORTUGAL
Co Author(s): M. Lima Fontes J. Meira A. Magalhães J. Breda F. Falcão-Reis
To present a 9-year follow up case of a 4 year-aged boy with lamellar cataract, who later developed visual acuity deterioration and acute progressive myopia.
Centro Hospitalar Universit�rio S�o Jo�o, Oporto, Portugal.
Clinical case presentation.
An healthy 4-year-old boy was referred for ophthalmology evaluation for bilateral uncorrected visual acuity of 2/10. Ocular alignment was normal. Objective refraction assessed by cycloplegic retinoscopy was -4.50-2.50x180�/-4.50-3.00x180�. Anterior segment evaluation revealed clusters of lens� opacities away from the visual axis. After refractory prescription, visual acuity was 7/10 in both eyes. During follow-up period, the nuclear component of the cataract developed, with acute progressive myopia (-8.00-3.00x30�/-6.50-3.00x30�) and visual acuity impairment. Bilateral phacoemulsification and placement of an intraocular toric lens (Acrysof I.Q. Toric) were performed. One month after surgery, visual acuity was 20/25 in both eyes, with minimal residual astigmatism.
Lamellar cataracts are one of the most common form of congenital cataracts. They are usually seen bilaterally in early childhood but may be congenital in onset. Due to their progressive nature, they can lead to severe impairment of visual acuity and amblyopia, thus having a surgical indication. Although it is a surgical challenge, the placement of intraocular toric lens in selected children provides a virtual postoperative emmetropia that contributes greatly to good functional result, better quality of life and satisfaction of the patients.
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