Comparative outcomes of early surgical versus conservative management in pediatric congenital cataracts: a systematic review of visual acuity and long-term ocular health
DOI:
https://doi.org/10.18203/2320-6012.ijrms20243458Keywords:
Pediatric congenital cataracts, Surgery vs conservative treatment, Visual acuity, Ocular health, Genetic mutations, Childhood blindnessAbstract
This systematic review compares early surgical and conservative management outcomes in paediatric congenital cataracts visual acuity and long-term ocular health. Paediatric cataracts are leading cause of treatable childhood blindness which affects 1 in 1,000 children with an estimated 200,000 children facing potential blindness from untreated or improperly managed cataracts. Untreated cataracts affect quality of life and impose socioeconomic burdens by impairing visual development. Pediatric cataracts are typically congenital and mostly caused by genetic abnormalities (particularly in crystallins and connexins) or acquired as a result of trauma or metabolic diseases. According to recent genetic research it is said that crystallin mutations are responsible for about half of solitary cataracts. This review categorized patients according to treatment type and examined visual results from 40 studies that used next-generation sequencing for genetic evaluation. Data on visual acuity and ocular health, and complication rates were taken from randomized trials and cohort studies that were systematically searched using sources such as PubMed and Cochrane. Findings indicate early surgical intervention offers improved visual outcomes but presents higher risks of postoperative complications while conservative management is preferable in cases with minimal opacity. Early management in these subtypes is supported by the greater advancement rates of genetic predispositions, especially connexin-related cataracts. Research says early surgery improves visual outcomes in cases where the patient is genetically predisposed, but it also demands lifelong follow-up to check problems. Future research should concentrate on improving surgical methods while assessing gene therapy's effectiveness in high-risk genotypes and increasing access to genetic testing for individualized treatment plans.
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