Abstract

Volume.127 Number.1

Original article : Case report

Relationship between the Timing of Surgery and Good Visual Outcome in Three Families of Three Generations with Hereditary Congenital Cataract
Teiji Yagasaki1,2, Yoshimi Yokoyama2, Kazuo Ichikawa2,3, Tatsushi Kaga2, Mana Yamamoto2
1 Yagasaki Eye Clinic
2 Department of Ophthalmology, Japan Community Health care Organization Chukyo Hospital
3 Chukyo Eye Clinic

Purpose: In dense congenital cataracts, bilateral and unilateral cases need to be treated surgically within the first 3 months and first 6 weeks, respectively, for a good outcome. Therefore, patients with hereditary cataracts are advised to seek consultation for their babies as early as possible. Here, we present three cases of patients who underwent early surgery during the critical period of visual development under appropriate guidance.
Cases: Case 1 was a 45-month-old boy who initially visited the hospital at the age of 8 days and underwent surgery for bilateral cataracts at the age of 8 weeks. Refractive correction with hard contact lenses (HCL) was performed from the seventh day after surgery. Intraocular lens (IOL) implantation was performed at the age of 1 year and 11 months, and corrected visual acuity (CVA) was found to be 0.8 in both eyes. Case 2 was a 9-year-old girl who initially visited the hospital at the age of 16 days and underwent surgery for bilateral cataracts at the age of 8 weeks. Refractive correction with HCL was performed from the 10th day after surgery. IOL implantation was performed at the age of 2 years and 7 months, and CVA was found to be 1.2 in both eyes. Case 3 was an 18-year-old girl who initially visited the hospital at the age of 8 days and underwent surgery for unilateral cataract (left eye) at the age of 8 weeks. Refractive correction with HCL was performed from the ninth day after surgery, and occlusion therapy was continued concurrently for a maximum of 50% of waking time. IOL implantation was performed on the left eye at the age of 2 years and 3 months, and left CVA was found to be 1.0. In all three cases, affected grandfathers or parents underwent cataract surgery; however, their visual acuity with counting fingers was approximately 0.6 and prognoses were poor.
Conclusions: For hereditary congenital cataracts, home guidance was provided and the babies were examined soon after birth. Therefore, patients with hereditary cataracts could seek consultation for their babies in the early period after birth. This guidance facilitates surgery during the critical period of visual development.
Nippon Ganka Gakkai Zasshi (J Jpn Ophthalmol Soc) 127: 32-37,2023.

Key words
Congenital cataract, Heredity, Form-vision deprivation amblyopia, Critical period, Early surgery
Reprint requests to
Teiji Yagasaki, M. D.　Yagasaki Eye Clinic. 62-6 Gonaka, Kaimei, Ichinomiya-shi, 494-0001, Japan
Received: 22 March 2022. Accepted in revised form: 1 August 2022.
Nihon Ganka Gakkai Zasshi 127: 32-37,2023