Surgery Improves Visual Function in Children With Posterior Lens Opacities

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Children receiving the procedure experienced improvements in visual acuity, modulator transfer function, and ocular aberrations.

Cataract surgery can be instrumental in improving visual function in children with posterior lens opacities, according to a study published in the American Journal of Ophthalmology

Researchers recruited pediatric patients (mean age 6.5±2.9 years, 69 eyes, 63 children) with posterior lens opacities for the analysis. Among the cohort, 43 eyes of 38 patients had posterior polar cataract and 26 eyes of 25 patients had posterior lenticonus. A majority of the cases were unilateral (57 unilateral cases, 6 bilateral cases). The team evaluated cataract type, location, area of opacity and strabismus and measured visual acuity, modulation transfer function (MTF), ocular aberrations, and stereopsis both pre and postoperatively.

Researchers found that corrected distance visual acuity (CDVA), MTF cut-off frequency, and ocular aberrations improved significantly following the procedure. They noted improvements in CDVA among children in both the posterior polar cataract and posterior lenticonus groups from baseline to postoperative status (0.81±0.53 to 0.40±0.40 logMAR; P <.001). Overall, 39 eyes (56.5%) achieved a good visual outcome (CDVA ≥ 20/40), including 23 eyes (53.5%) in the posterior polar cataract group and 16 eyes (61.5%) in the posterior lenticonus group. MTF cut-off values improved, total ocular aberrations were lower, and stereopsis improved significantly at the final visit (P <.001 for all). 

Researchers note that good visual outcomes were not associated with age at time of surgery, cataract type, location of lens opacity, posterior capsular rupture, or IOL implantation position. Risk factors associated with worse postoperative CDVA included worse preoperative CDVA, larger size of lens opacities, and larger mean keratometry (all P < .05). 

Study limitations include the relatively small cohort, inability to obtain MTF cutoff frequency measurements for some patients, and the evaluation of optical parameters using a 4.0-mm pupillary diameter. 


Chen W, Chen H, Lin Z, et al. Visual function in children with posterior lens opacities before and after surgery. Am J Ophthalmol. Published online May 2, 2022. doi:10.1016/j.ajo.2022.04.018