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    Cataract, glaucoma collision sparks MIGS, other innovation

    Phaco defined shift in treatment, expansion in provision of global eye care into future



    Pediatric ophthalmology

    Surgeons realized that their growing experience with smaller incisions in adult eyes could be translated directly to pediatric eyes. Pediatric conditions—such as Marfan syndrome or ectopic lentis that once had less-than-ideal outcomes—can now be treated much more successfully using Ahmed capsular tension segments and other techniques designed for adult eyes.

    “The standard procedure for Marfan syndrome is lensectomy, vitrectomy, and then you sew a lens to the sclera,” Dr. Crandall noted. 

    “Then you have fairly high rates of retinal detachment and secondary glaucoma,” he said. “When you apply what we’ve learned from phaco and small incisions and treating complicated adult eyes, you reduce the rate of both retinal detachment and secondary glaucoma in these kids to near zero. It’s a huge change.”

    The numbers of patients are relatively small, he noted, simply because the prevalence of complex pediatric eye disease is relatively low. Thanks to technologies developed for complicated adult cataracts, late complication rates in pediatric patients have fallen dramatically.

    Fred Gebhart
    The author is a correspondent for Urology Times, a sister publication.

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