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Treating Amblyopia in Aphakic and Pseudophakic Children

Correspondence: Requests for reprints should be addressed to: Scott R. Lambert, M.D., Emory Eye Center, 1365-B Clifton Road, N.E., Suite B4500, Atlanta, GA 30322; e-mail: slamber{at}emory.edu

Introduction Amblyopia is the leading cause of reduced vision in children following cataract surgery. It may develop as a consequence of visual deprivation, anisometropia, or strabismus.

Methods: Animal studies as well as clinical series were reviewed focusing on the pathophysiology and treatment of aphakic and pseudophakic amblyopia.

Results: Excellent visual outcomes have been reported in children with unilateral congenital cataracts following early cataract surgery, optical correction, and part-time patching of their phakic eyes. Progressive patching regimens may help to preserve the binocularity of children following unilateral cataract surgery. Excellent visual outcomes can also be achieved in children with bilateral congenital cataracts if cataract surgery and optical correction are initiated prior to the onset of nystagmus.

Conclusions: Amblyopia is the greatest threat to the vision of children following cataract surgery. Constant vigilance is necessary to treat and prevent amblyopia in these children.

Key words: amblyopia, cataract surgery, patching, aphakia