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. 2011 Oct;15(5):421-6.
doi: 10.1016/j.jaapos.2011.05.016.

The Infant Aphakia Treatment Study: evaluation of cataract morphology in eyes with monocular cataracts

M Edward Wilson  1 , Rupal H Trivedi, David G Morrison, Scott R Lambert, Edward G Buckley, David A Plager, Michael J Lynn; Infant Aphakia Treatment Study Group
Affiliations

The Infant Aphakia Treatment Study: evaluation of cataract morphology in eyes with monocular cataracts

M Edward Wilson et al. J AAPOS. 2011 Oct.

Abstract

Purpose: To describe a video-documented assessment of cataract type in the eyes of patients with monocular infantile cataract who were enrolled in the Infant Aphakia Treatment Study.

Methods: The Infant Aphakia Treatment Study is a randomized clinical trial in which the investigators compared intraocular lens (IOL) versus contact lens correction in 114 infants, aged 28 days to <7 months. A total of 83 videos were available for morphological analysis of cataract. Three examiners reviewed all surgical recordings and agreed on the cataract characteristics by using a score sheet to record the lens layer or configuration of the opacity.

Results: Nuclear cataract was present in 45 of 83 eyes (54%). Posterior capsule plaque was observed in 73 eyes (88%). All eyes with fetal nuclear cataract had associated posterior capsule plaque. Cortical cataract without nuclear involvement was seen in 21 eyes (25%). Posterior bowing of the posterior capsule was noted in 4 eyes (5%). Evidence of persistent fetal vasculature (PFV) was present in 18 eyes (22%). PFV was the only finding in 5 eyes but was also seen in combination with nuclear (7 eyes) and cortical cataracts (6 eyes). The entire lens was white in 3 eyes (4%), whereas the lens was partially resorbed in 7 (8%) eyes. Anterior capsule fibrosis was noted in 5 eyes with advanced cataract (1 with total cataract, 4 with partially resorbed lens).

Conclusions: Nuclear opacities were common, but many different cataract types presented in infancy. PFV occurred in isolation or in association with cataract. Posterior capsule plaque was frequently noted, especially when a nuclear cataract was present.

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Figures

FIG 1
FIG 1
A, Fetal nuclear cataract with spread into the surrounding cortex. B, Posterior capsule plaque visible after the cataract was aspirated.
FIG 2
FIG 2
A, Cortical cataract with small central posterior plaque. B, Persistent fetal vasculature: mild involvement with a small plaque, a few vessels and a nonpatent hyaloid remnant. C, Persistent fetal vasculature: dense retrolenticular plaque with stretched ciliary processes (arrow) that became visible after cataract aspiration. D, Posterior lentiglobus.
FIG 3
FIG 3
A, Complete cataract. B, Anterior capsule fibrosis (same eye as 3A).
See this image and copyright information in PMC

Comment in

References

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