Congenital Cataract

[Ghen]

My daughter is 4 years old now and she was born with congenital cataract. She had surgery when she was 2 months old then after she wore a +10 eyeglasses. We had a regular check up with our opthalmologist but sad to say that after 2 years he migrated in USA, we are from Philippines. For two years we did'nt know where to go since there are few pediatric opthalomogist here in the Philippines. While searching online we found a team of opthalmologist we went to their pediatric ophthalmologist and was advised to have an ultrasound for the eyes. With the result we were advised to have a lens implant and we were told also that there was inflammation after surgery. We were referred to an aphakic specialist good thing that he is also a uveitis specialist. The aphakic specialist discussed to us the risks of the surgery, the diagnosis are miotic pupil, nystagmus, microcornea. Currently my daughter is wearing +18 eyeglasses.

We want to hear your opinion on these, with your experiences how much is the possibility of losing her vision if she undergo surgery and if she doesn't? Thanks!

[Ghen]

We are now planning when to have the lens implant for my daughter since the school
year will end this March here in Philippines. Our opthalmologist requested for IOL
master and Ocuscan. He's very honest to us that this will be his first time to handle
a case like my daughter. While researching online to educate myself more about my
daughter's case I found another team of opthalmologist, we set an appointment with
their pediatric opthalomologist who is also an aphakic specialist. During the
discussion he mentioned that the lens will be placed behind the iris with stitches because if it will be infront in case there'll be inflammation (not sure of the exact term) there's a possibility of corneal damage. I remember with our first opthalmologist he said that lens will be placed infront of the iris. There's no longer ___ inside where the lens can hold. (I apologize I don't know the exact term I cant remember the exact word used buy our opthalmologist.)

What can you say about this?

[Ray T Oyakawa, MD]

Thick glasses are never a good thing for children.  Many of my lasik patients were teased as a child and they had much thinner myopic glasses.

An implant is preferred to a +18 aphakic spectacle.  If the surgery resulted in total loss of vision, no other surgery will restore sight.  This is very unlikely.  There may be some complications that require more surgery.

[Ghen]

Thank you very much. Our doctor discussed already the benefits and the risks with surgery. If we won't go for surgery what are the possibilities in  the future?

As parents we are concern of how is my daughter going to take it in case something bad happens. Despite of her poor vision she does everything that a normal child can do she goes to a regular school and is doing very good, she plays with other kids.

In case she lost her vision are there any other surgery that can be done?

[Ray T Oyakawa, MD]

There is always a chance of loosing her vision with surgery.  She has a number of problems but I believe your best bet is surgery.  Aphakic children, especially, a +18 would do better with a lens implant at this age.

You need to discusses with the doctor the benefits and risks.