Poster 233

by in  Poster Session 3

Assessment of the Necessity for Surgical Intervention in Unilateral Pediatric Cataract

Michael C. Struck; Yasmin Bradfield
University of Wisconsin, Madison
Madison, WI


Introduction: We describe the use of Sweep Visual Evoked Potential (SVEP) as a surrogate for accurate, objective measure of visual acuity and therefore need for surgical intervention, in our preverbal pediatric patients with unilateral cataract.

Methods: 30 pediatric preverbal children in the amblyopic age with unilateral cataract were included. Analysis of final corrected visual acuity with blocked HOTV or linear Snellen. Ad-hoc analysis of pre-operative features relating to need for surgical intervention were analyzed.

Results: Normal visual maturation by SVEP is found to follow a logarithmic growth curve. A graph provides logarithmic analysis for normal visual development by SVEP vision recordings over the first three years of life. Children who did not maintain logarithmic vision development underwent surgical intervention. Ad-hoc analysis showed that successful non-surgical treatment of unilateral cataract was highly correlated to ability to achieve endpoint in retinoscopy, compliance with 4 hours/day occlusion therapy and absence of strabismus.

Discussion: Determination of the need for intervention traditionally has been based on morphologic features of the cataract alone. We have found the use of SVEP along with retinoscopic reflex and compliance to occlusion therapy a useful guide to successful visual outcome in pediatric cataract.

Conclusion: The SVEP recording provides logarithmic data of acuity development in preliterate children, which we found critical in assessing the need for intervention.

References: Travi GM, Schnall BM, Lehman SS. Visual outcome and success of amblyopia treatment in unilateral small posterior lens opacities and lenticonus initially treated nonsurgically.  J AAPOS.  2005;9:449-454.
Merin S, Crawford JS. Assessment of incomplete congenital cataract. Can J Ophthalmol 1972; 7: 56–62.
Zetterstrom C, Lundvall A, Kugelbert M. Cataracts in children. J Cataract Refract Surg. 2005;31:824–840.

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