Congenital cataract is the most common cause of treatable blindness in children. With the continuous improvement of surgical techniques, clinical success rates have been greatly improved. However, successful surgery is just the first step in visual functional recovery. The establishment of a specialized
pediatric ophthalmic treatment system that selects the appropriate indications and timing of surgery is of great importance. The system could help surgeons master congenital cataract-specific surgical skills and improve standard refractive correction, amblyopia treatment, and binocular vision training.
World Health Organization. Blindness and Deafness Unit International Agency for the Prevention of Blindness. Preventing blindness in children: report of a WHO/IAPB scientific meeting,Hyderabad, India,13-17 April 1999. Geneva: World HealthOrganization, 2000.
[2]
Kong L, Fry M, Al-Samarraie M, et al. An update on progress and the changing epidemiology of causes of childhood blindness worldwide. J AAPOS, 2012, 16(6): 501-507. DOI: 10.1016/j.jaapos.2012.09.004.
[4]
Wilson ME, Pandey SK, Thakur J. Paediatric cataract blindness in the developing world: surgical techniques and intraocular lenses in the new millennium. Br J Ophthalmol, 2003, 87(1): 14-19.
Cao Q, Lin Y, Xie Z, et al. Comparison of sedation by intranasal dexmedetomidine and oral chloral hydrate for pediatric ophthalmic examination. Paediatr Anaesth, 2017, 27(6): 629-
63
6. DOI: 10.1111/pan.13148.
[4]
Wilson ME, Pandey SK, Thakur J. Paediatric cataract blindness in the developing world: surgical techniques and intraocular lenses in the new millennium. Br J Ophthalmol, 2003, 87(1): 14-19.
[6]
Lin Y, Chen Y, Huang J, et al. Efficacy of premedication with intranasal dexmedetomidine on inhalational induction and postoperative emergence agitation in pediatric undergoing
cataract surgery with sevoflurane. J Clin Anesth, 2016, 33: 289-295. DOI: 10.1016/j.jclinane.2016.04.027.
[7]
Lin H, Chen W, Luo L, et al. Effectiveness of a short message reminder in increasing compliance with pediatric cataract treatment: a randomized trial. Ophthalmology, 2012, 119(12):2463-2470. DOI: 10.1016/j.ophtha.2012.06.046.
[5]
Cao Q, Lin Y, Xie Z, et al. Comparison of sedation by intranasal dexmedetomidine and oral chloral hydrate for pediatric ophthalmic examination. Paediatr Anaesth, 2017, 27(6): 629-
63
6. DOI: 10.1111/pan.13148.
[8]
Lin H, Lin D, Liu Z, et al. A Novel Congenital Cataract Category System Based on Lens Opacity Locations and Relevant Anterior Segment Characteristics. Invest Ophthalmol
[6]
Lin Y, Chen Y, Huang J, et al. Efficacy of premedication with intranasal dexmedetomidine on inhalational induction and postoperative emergence agitation in pediatric undergoing
cataract surgery with sevoflurane. J Clin Anesth, 2016, 33: 289-295. DOI: 10.1016/j.jclinane.2016.04.027.
[7]
Lin H, Chen W, Luo L, et al. Effectiveness of a short message reminder in increasing compliance with pediatric cataract treatment: a randomized trial. Ophthalmology, 2012, 119(12):2463-2470. DOI: 10.1016/j.ophtha.2012.06.046.
Vis Sci, 2016, 57(14): 6389-6395
[9]
Long E, Lin H, Liu Z, et al. An artificial intelligence platform for the multihospital collaborative management of congenital cataracts. Nature biomedical engineering, 2017, 1(2). DOI: 10.1038/s41551-016-0024.
[10]
Zetterström C, Lundvall A, Kugelberg M. Cataracts in children.J Cataract Refract Surg, 2005, 31(4): 824-840. DOI: 10.1016/j.jcrs.2005.01.012.
[11]
Hubel DH, Wiesel TN. Laminar and columnar distribution of geniculo-cortical fibers in the macaque monkey. J Comp Neurol,1972, 146(4): 421-450. DOI: 10.1002/cne.901460402.
[12]
Lin H, Chen W, Luo L, et al. Ocular hypertension after pediatric cataract surgery: baseline characteristics and first-year report. PLoS One, 2013, 8(7): e69867. DOI: 10.1371/journal.
[8]
Lin H, Lin D, Liu Z, et al. A Novel Congenital Cataract Category System Based on Lens Opacity Locations and Relevant Anterior Segment Characteristics. Invest Ophthalmol
pone.0069867.
Vis Sci, 2016, 57(14): 6389-6395
[9]
Long E, Lin H, Liu Z, et al. An artificial intelligence platform for the multihospital collaborative management of congenital cataracts. Nature biomedical engineering, 2017, 1(2). DOI: 10.1038/s41551-016-0024.
[10]
Zetterström C, Lundvall A, Kugelberg M. Cataracts in children.J Cataract Refract Surg, 2005, 31(4): 824-840. DOI: 10.1016/j.jcrs.2005.01.012.
[11]
Hubel DH, Wiesel TN. Laminar and columnar distribution of geniculo-cortical fibers in the macaque monkey. J Comp Neurol,1972, 146(4): 421-450. DOI: 10.1002/cne.901460402.
[12]
Lin H, Chen W, Luo L, et al. Ocular hypertension after pediatric cataract surgery: baseline characteristics and first-year report. PLoS One, 2013, 8(7): e69867. DOI: 10.1371/journal.
[13]
Mataftsi A, Haidich AB, Kokkali S, et al. Postoperative glaucoma following infantile cataract surgery: an individual patient data meta-analysis. JAMA Ophthalmol, 2014, 132(9):
10
59-1067. DOI: 10.1001/jamaophthalmol.2014.1042.
pone.0069867.
[14]
Birch EE, Stager DR. The critical period for surgical treatment of dense congenital unilateral cataract. Invest Ophthalmol Vis Sci, 1996, 37(8): 1532-1538.
[15]
Hartmann EE, Lynn MJ, Lambert SR. Baseline characteristics of the infant aphakia treatment study population: predicting recognition acuity at 4.5 years of age. Invest Ophthalmol VisSci, 2014, 56(1): 388-395. DOI: 10.1167/iovs.14-15464.
[16]
Lambert SR, Lynn MJ, Reeves R, et al. Is there a latent period for the surgical treatment of children with dense bilateral congenital cataracts? J AAPOS, 2006, 10(1): 30-36. DOI:
[13]
Mataftsi A, Haidich AB, Kokkali S, et al. Postoperative glaucoma following infantile cataract surgery: an individual patient data meta-analysis. JAMA Ophthalmol, 2014, 132(9):
10
59-1067. DOI: 10.1001/jamaophthalmol.2014.1042.
10
1016/j.jaapos.2005.10.002.
[14]
Birch EE, Stager DR. The critical period for surgical treatment of dense congenital unilateral cataract. Invest Ophthalmol Vis Sci, 1996, 37(8): 1532-1538.
[15]
Hartmann EE, Lynn MJ, Lambert SR. Baseline characteristics of the infant aphakia treatment study population: predicting recognition acuity at 4.5 years of age. Invest Ophthalmol VisSci, 2014, 56(1): 388-395. DOI: 10.1167/iovs.14-15464.
[16]
Lambert SR, Lynn MJ, Reeves R, et al. Is there a latent period for the surgical treatment of children with dense bilateral congenital cataracts? J AAPOS, 2006, 10(1): 30-36. DOI:
[17]
Jensen AA, Basti S, Greenwald MJ, et al. When may the posterior capsule be preserved in pediatric intraocular lens surgery? Ophthalmology, 2002, 109(2): 324-327; 328.
[18]
Lin H, Tan X, Lin Z, et al. Capsular Outcomes Differ with Capsulorhexis Sizes after Pediatric Cataract Surgery: A Randomized Controlled Trial. Sci Rep, 2015, 5: 16227. DOI:
10
1016/j.jaapos.2005.10.002.
10
1038/srep16227.
[19]
Chee KY, Lam GC. Management of congenital cataract in children younger than 1 year using a 25-gauge vitrectomy system. J Cataract Refract Surg, 2009, 35(4): 720-724. DOI:
[17]
Jensen AA, Basti S, Greenwald MJ, et al. When may the posterior capsule be preserved in pediatric intraocular lens surgery? Ophthalmology, 2002, 109(2): 324-327; 328.
[18]
Lin H, Tan X, Lin Z, et al. Capsular Outcomes Differ with Capsulorhexis Sizes after Pediatric Cataract Surgery: A Randomized Controlled Trial. Sci Rep, 2015, 5: 16227. DOI:
10
1016/j.jcrs.2008.12.012.
10
1038/srep16227.
[19]
Chee KY, Lam GC. Management of congenital cataract in children younger than 1 year using a 25-gauge vitrectomy system. J Cataract Refract Surg, 2009, 35(4): 720-724. DOI:
[20]
Luo L, Lin H, Chen W, et al. In-the-bag intraocular lens placement via secondary capsulorhexis with radiofrequency diathermy in pediatric aphakic eyes. PLoS One, 2013, 8(4):
e62381. DOI: 10.1371/journal.pone.0062381.
[21]
Dick HB, Schultz T. Femtosecond laser-assisted cataract surgery in infants. J Cataract Refract Surg, 2013, 39(5): 665-668. DOI:
10
1016/j.jcrs.2008.12.012.
10
1016/j.jcrs.2013.02.032.
[22]
Lin H, Ouyang H, Zhu J, et al. Lens regeneration using endogenous stem cells with gain of visual function. Nature, 2016, 531(7594): 323-328. DOI: 10.1038/nature17181.
[23]
Chan WH, Biswas S, Ashworth JL, et al. Congenital and infantile cataract: aetiology and management. Eur J Pediatr, 2012, 171(4): 625-630. DOI: 10.1007/s00431-012-1700-1.
[20]
Luo L, Lin H, Chen W, et al. In-the-bag intraocular lens placement via secondary capsulorhexis with radiofrequency diathermy in pediatric aphakic eyes. PLoS One, 2013, 8(4):
e62381. DOI: 10.1371/journal.pone.0062381.
[21]
Dick HB, Schultz T. Femtosecond laser-assisted cataract surgery in infants. J Cataract Refract Surg, 2013, 39(5): 665-668. DOI:
[24]
Plager DA, Lynn MJ, Buckley EG, et al. Complications in the first 5 years following cataract surgery in infants with and without intraocular lens implantation in the Infant Aphakia
Treatment Study. Am J Ophthalmol, 2014, 158(5): 892-898.DOI: 10.1016/j.ajo.2014.07.031.
[25]
Solebo AL, Russell-Eggitt I, Cumberland PM, et al. Risks and outcomes associated with primary intraocular lens implantation in children under 2 years of age: the IoLunder2 cohort study. Br J Ophthalmol, 2015, 99(11): 1471-1476. DOI: 10.1136/ bjophthalmol-2014-306394.
[26]
Lin H, Lin D, Chen J, et al. Distribution of Axial Length before Cataract Surgery in Chinese Pediatric Patients. Sci Rep, 2016, 6:23862. DOI: 10.1038/srep23862.
[27]
Wilson ME, Trivedi RH, Weakley DR, et al. Globe Axial Length Growth at Age 5 Years in the Infant Aphakia Treatment Study. Ophthalmology, 2017, 124(5): 730-733. DOI: 10.1016/j.ophtha.2017.01.010.
10
1016/j.jcrs.2013.02.032.
[22]
Lin H, Ouyang H, Zhu J, et al. Lens regeneration using endogenous stem cells with gain of visual function. Nature, 2016, 531(7594): 323-328. DOI: 10.1038/nature17181.
[23]
Chan WH, Biswas S, Ashworth JL, et al. Congenital and infantile cataract: aetiology and management. Eur J Pediatr, 2012, 171(4): 625-630. DOI: 10.1007/s00431-012-1700-1.
[28]
Cooke DL. Predictability of intraocular lens power calculation formulae in infantile eyes with unilateral congenital cataract:results from the infant aphakia treatment study. Am J
Plager DA, Lynn MJ, Buckley EG, et al. Complications in the first 5 years following cataract surgery in infants with and without intraocular lens implantation in the Infant Aphakia
Treatment Study. Am J Ophthalmol, 2014, 158(5): 892-898.DOI: 10.1016/j.ajo.2014.07.031.
[25]
Solebo AL, Russell-Eggitt I, Cumberland PM, et al. Risks and outcomes associated with primary intraocular lens implantation in children under 2 years of age: the IoLunder2 cohort study. Br J Ophthalmol, 2015, 99(11): 1471-1476. DOI: 10.1136/ bjophthalmol-2014-306394.
[26]
Lin H, Lin D, Chen J, et al. Distribution of Axial Length before Cataract Surgery in Chinese Pediatric Patients. Sci Rep, 2016, 6:23862. DOI: 10.1038/srep23862.
[27]
Wilson ME, Trivedi RH, Weakley DR, et al. Globe Axial Length Growth at Age 5 Years in the Infant Aphakia Treatment Study. Ophthalmology, 2017, 124(5): 730-733. DOI: 10.1016/j.ophtha.2017.01.010.
[29]
Gordon RA, Donzis PB. Refractive development of the human eye. Arch Ophthalmol, 1985, 103(6): 785-789.
[28]
Cooke DL. Predictability of intraocular lens power calculation formulae in infantile eyes with unilateral congenital cataract:results from the infant aphakia treatment study. Am J
Enyedi LB, Peterseim MW, Freedman SF, et al. Refractive changes after pediatric intraocular lens implantation. Am J
[29]
Gordon RA, Donzis PB. Refractive development of the human eye. Arch Ophthalmol, 1985, 103(6): 785-789.
Ophthalmol, 1998, 126(6): 772-781.
[31]
Weakley DR, Lynn MJ, Dubois L, et al. Myopic Shift 5 Years after Intraocular Lens Implantation in the Infant Aphakia Treatment Study. Ophthalmology, 2017, 124(6): 822-827. DOI:10.1016/j.ophtha.2016.12.040.[32] Dahan E, Drusedau MU. Choice of lens and dioptric power in pediatric pseudophakia. J Cataract Refract Surg, 1997, 23 Suppl1: 618-623.
[30]
Enyedi LB, Peterseim MW, Freedman SF, et al. Refractive changes after pediatric intraocular lens implantation. Am J
[33]
Flitcroft DI, Knight-Nanan D, Bowell R, et al. Intraocular lenses in children: changes in axial length, corneal curvature, and refraction. Br J Ophthalmol, 1999, 83(3): 265-269.
Ophthalmol, 1998, 126(6): 772-781.
[31]
Weakley DR, Lynn MJ, Dubois L, et al. Myopic Shift 5 Years after Intraocular Lens Implantation in the Infant Aphakia Treatment Study. Ophthalmology, 2017, 124(6): 822-827. DOI:10.1016/j.ophtha.2016.12.040.[32] Dahan E, Drusedau MU. Choice of lens and dioptric power in pediatric pseudophakia. J Cataract Refract Surg, 1997, 23 Suppl1: 618-623.
[34]
Hutchinson AK, Drews-Botsch C, Lambert SR. Myopic shift after intraocular lens implantation during childhood.Ophthalmology, 1997, 104(11): 1752-1757.
Flitcroft DI, Knight-Nanan D, Bowell R, et al. Intraocular lenses in children: changes in axial length, corneal curvature, and refraction. Br J Ophthalmol, 1999, 83(3): 265-269.
[36]
Wilson ME, Trivedi RH, Hoxie JP, et al. Treatment outcomes of congenital monocular cataracts: the effects of surgical timing and patching compliance. J Pediatr Ophthalmol Strabismus,2003, 40(6): 323-329; quiz 353-354.
[37]
VanderVeen DK, Nizam A, Lynn MJ, et al. Predictability of intraocular lens calculation and early refractive status: the Infant Aphakia Treatment Study. Arch Ophthalmol, 2012, 130(3): 293-299. DOI: 10.1001/archophthalmol.2011.358.
[38]
Ford J, Werner L, Mamalis N. Adjustable intraocular lens power technology. J Cataract Refract Surg, 2014, 40(7): 1205-1223.DOI: 10.1016/j.jcrs.2014.05.005.
[39]
Infant Aphakia Treatment Study Group, Lambert SR, Lynn MJ,et al. Comparison of contact lens and intraocular lens correction of monocular aphakia during infancy: a randomized clinical trial of HOTV optotype acuity at age 4.5 years and clinical findings at age 5 years. JAMA Ophthalmol, 2014, 132(6): 676-682. DOI:10.1001/jamaophthalmol.2014.531.
[40]
Wall PB, Lee JA, Lynn MJ, et al. The effects of surgical factors on postoperative astigmatism in patients enrolled in the Infant Aphakia Treatment Study (IATS). J AAPOS, 2014, 18(5): 441-445. DOI: 10.1016/j.jaapos.2014.06.016.
[41]
Hartmann EE, Stout AU, Lynn MJ, et al. Stereopsis results at 4.5 years of age in the infant aphakia treatment study. Am J Ophthalmol, 2015, 159(1): 64-70. DOI:10.1016/j.ajo.2014.09.028.
[34]
Hutchinson AK, Drews-Botsch C, Lambert SR. Myopic shift after intraocular lens implantation during childhood.Ophthalmology, 1997, 104(11): 1752-1757.
Lambert SR, DuBois L, Cotsonis G, et al. Factors associated with stereopsis and a good visual acuity outcome among children in the Infant Aphakia Treatment Study. Eye (Lond),
20
16, 30(9): 1221-1228. DOI: 10.1038/eye.2016.164.
[43]
Clavagnier S, Thompson B, Hess RF. Long lasting effects of daily theta burst rTMS sessions in the human amblyopic cortex. Brain Stimul, 2013, 6(6): 860-867. DOI: 10.1016/
[36]
Wilson ME, Trivedi RH, Hoxie JP, et al. Treatment outcomes of congenital monocular cataracts: the effects of surgical timing and patching compliance. J Pediatr Ophthalmol Strabismus,2003, 40(6): 323-329; quiz 353-354.
[37]
VanderVeen DK, Nizam A, Lynn MJ, et al. Predictability of intraocular lens calculation and early refractive status: the Infant Aphakia Treatment Study. Arch Ophthalmol, 2012, 130(3): 293-299. DOI: 10.1001/archophthalmol.2011.358.
[38]
Ford J, Werner L, Mamalis N. Adjustable intraocular lens power technology. J Cataract Refract Surg, 2014, 40(7): 1205-1223.DOI: 10.1016/j.jcrs.2014.05.005.
[39]
Infant Aphakia Treatment Study Group, Lambert SR, Lynn MJ,et al. Comparison of contact lens and intraocular lens correction of monocular aphakia during infancy: a randomized clinical trial of HOTV optotype acuity at age 4.5 years and clinical findings at age 5 years. JAMA Ophthalmol, 2014, 132(6): 676-682. DOI:10.1001/jamaophthalmol.2014.531.
[40]
Wall PB, Lee JA, Lynn MJ, et al. The effects of surgical factors on postoperative astigmatism in patients enrolled in the Infant Aphakia Treatment Study (IATS). J AAPOS, 2014, 18(5): 441-445. DOI: 10.1016/j.jaapos.2014.06.016.
[41]
Hartmann EE, Stout AU, Lynn MJ, et al. Stereopsis results at 4.5 years of age in the infant aphakia treatment study. Am J Ophthalmol, 2015, 159(1): 64-70. DOI:10.1016/j.ajo.2014.09.028.
j.brs.2013.04.002.
[42]
Lambert SR, DuBois L, Cotsonis G, et al. Factors associated with stereopsis and a good visual acuity outcome among children in the Infant Aphakia Treatment Study. Eye (Lond),
20
16, 30(9): 1221-1228. DOI: 10.1038/eye.2016.164.
[43]
Clavagnier S, Thompson B, Hess RF. Long lasting effects of daily theta burst rTMS sessions in the human amblyopic cortex. Brain Stimul, 2013, 6(6): 860-867. DOI: 10.1016/