Pediatric cataracts: clinical aspects, frequency of strabismus and chronological, etiological, and morphological features

PURPOSE: This study aimed to evaluate the frequency of strabismus and chronological, etiological, and morphological features in patients with pediatric cataracts. METHODS: Medical records of pediatric patients were evaluated at the Congenital Cataract Section, Department of Ophthalmology, Federal University of São Paulo, from 2001 to 2011. Patients with congenital cataract or developmental cataract were included. The patients with traumatic cataract, cataract secondary to uveitis, radiation or drugs, aphakic or pseudophakic patients who underwent surgery in another hospital, patients with glaucoma, non-lenticular leukocorias (retinoblastoma, retinopathy of prematurity, prelenticular leukocorias), and lens subluxation were excluded from the study. The following outcomes were evaluated: frequency of chronological, etiological, and morphological features, laterality, and occurrence of associated strabismus. RESULTS: A total of 207 patients were included. One hundred and seventeen patients (56.5%) had congenital cataract and 90 patients (43.5%) had developmental cataract. One hundred and nine patients (52.6%) had unilateral cataract. In terms of morphology, 72 children (33.8%) had zonular cataract and 66 (31.9%) had total cataract. Idiopathic cataract affected 150 patients (72.5%). There were 108 patients (52.2%) with strabismus, mainly secondary esotropia. CONCLUSION: Idiopathic etiology was the most frequent cause in this group of patients. Zonular cataract was the main morphological type of cataract in the study. Unilateral cataract occurred more frequently in patients with persistent fetal vasculature (PFV). Strabismus presented in 52% of the patients. The current analysis may help establish an earlier and more accurate diagnosis of pediatric cataracts.