A survey of the surgical treatment of congenital and developmental cataracts in Japan

Purpose: To understand the current practice pattern for the surgical treatment of congenital/developmental cataracts in Japan. Methods: A mail questionnaire was sent to facilities engaged in thesurgical treatment of congenital cataracts in Japan. Results: Thirty-four facilities reported their preferred methods for the surgical treatment of congenital cataracts, including data from 809 eyes of 508 patients who had undergone surgery. More than 85 % of the respondents answered that they would consider surgery even if the visual prognosis was not promising because of possible form-deprivation amblyopia. The most commonly performed surgical maneuvers were scleral tunnel incision (88.4 %), 3.0-mm or smaller incision (78.8 %), manual anterior continuous curvilinear capsulorhexis (90.2 % success rate), posterior capsulotomy (92.5 % for patients aged ≤6 years), anterior vitrectomy by the limbal approach (85.9 % for patients aged ≤6 years), and wound closure with sutures (93.2 %). Posterior capsulotomy and vitrectomy were not usually performed in patients aged >6 years. Implantation of an intraocular lens (IOL) was mostly indicated in patients aged 2 years or older. Implantation of an acrylic foldable IOL (76.6 %) into the capsular bag (89.7 %) was the most common practice among the surgeons. Conclusions: Small incision surgery with implantation of an acrylic foldable IOL into the capsular bag combined with posterior capsulotomy was the preferred surgical treatment of choice for congenital/developmental cataracts.