FRINK Linked Data Fragments server

Matches in SemOpenAlex for { <https://semopenalex.org/work/W4313454041> ?p ?o ?g. }

• W4313454041 endingPage "138" @default.
• W4313454041 startingPage "138" @default.
• W4313454041 abstract "Cataracts in children can be found as isolated cases or associated with various systemic conditions. Some of these disorders can be quite morbid or even life-threatening, hence overall management of these children is very important. Common systemic associations of pediatric cataracts include periventricular leukomalacia (PVL), Down Syndrome, Marfan syndrome, cardiac valvular abnormalities, hypothyroidism, TORCH infections, seizure disorder, cerebral palsy, nephrotic syndrome, type 1 diabetes mellitus, and microcephaly. A recent study published in the current issue of the journal highlights the systemic associations of pediatric cataracts.[1] We congratulate the authors for studying this important aspect as the systemic condition itself maybe the etiology of the cataracts in children. As highlighted by the authors, visual functions may not be fully developed in these children and they may have a large component of amblyopia. Additionally, a thorough ocular examination, including measuring visual acuity, may be difficult in these children. Bilateral simultaneous cataract surgery is an alternative in these children who are “at risk” of general anesthesia. The study, however, is low powered to understand the psychosocial impact of these conditions on the child. Several patients in the study were left aphakic and a longer follow-up is lacking. We further detail some important points to be taken into consideration before proceeding for cataract surgery in children with systemic comorbidities. Preoperative evaluation in all of these children should be done by a pediatrician. Detailed cardiac evaluation is warranted in children with Down syndrome, preexisting cardiac valvular abnormalities, Marfan syndrome, and Rubella group of infections. The parents must be explained the risk of general anesthesia in such children. Apart from cardiac anomalies, children with Down syndrome can have macroglossia, subglottic stenosis, and atlantooccipital joint instability leading to difficult intubation. Down syndrome is also associated with esotropia, nystagmus, hyperopia, astigmatism, and poor accommodative ability (hence needs dynamic retinoscopy). Conditions like blepharitis and nasolacrimal duct obstruction in these children are common and hence should be taken care of before surgery. These children are at a 30-time higher risk of developing keratoconus. Therefore, appropriate refractive rehabilitation should be provided to these children post surgery.[2] Often, we operate on children who have history of seizures. All of these children should undergo a detailed retinal examination and consultation from a pediatric neurologist as a fraction of them may have Aicardi syndrome, associated with chorioretinal lacunae and optic atrophy. The parents must be counseled accordingly about the postoperative suboptimal visual outcomes.[3] Children with Marfan syndrome must be counseled about the risk of aphakia and the need for high-power glasses or contact lenses if subjected to lensectomy. A life-long follow-up for breaks and retinal detachment is needed.[4] At the same time, an evaluation for cardiac anomalies, such as mitral regurgitation and dilation of the aorta, in these children is a must. Children with hypothyroidism can have macroglossia and short neck which can lead to difficult intubation. These children are prone to hypothermia, and the physician should be watchful of.[5] Maternal infection of TORCH can present with retinochoroidal lesions other than cataract. The most common ocular manifestation of rubella infection is pigmentary retinopathy. It can be associated with corneal opacities and micro-ophthalmia. Furthermore, a cardiology consultation should be taken for screening for congenital heart diseases such as pulmonary artery stenosis and patent ductus arteriosus.[67] Before cataract surgery, it is important to have long-term well-controlled sugar levels in patients with type 1 diabetes. Postoperative deranged sugar levels hamper wound healing and increase the risk of endophthalmitis. These patients should also be advised for regular screening for diabetic retinopathy.[8] It is of utmost importance to explain to parents about punctal occlusion after administering steroid drops because systemic absorption can cause hyperglycemia and can cause hypothalamic-pituitary axis suppression and life-threatening hypoglycemia in conditions like diabetes and hypothyroidism in the long run.[910] As the nephrotic syndrome is associated with long-term steroid use, screening for glaucoma in these children is important. These children are prone to infections (loss of immunoglobins through urine) and postoperative follow-up should be more frequent, especially in the early postoperative period.[9] A recent study reported a large series of systemic comorbidities in children with pediatric cataracts.[11] An identifiable cause could be found in 55%–66% of the cases. Hence, it is also important to note that cataracts may be the first presenting sign of an ominous hidden underlying disease. Overall, many of the systemic associations highlighted in the paper may have a significant component of cortical vision impairment. It is important to identify this aspect and explain to the parents the need for long-term follow-up, visual stimulation, and visual rehabilitation even after a well-performed cataract surgery. The surgical outcomes in these children may be like any case of pediatric cataract but the overall outcome is affected by the delay in presentation, delay in surgery due to fitness for anesthesia, dense amblyopia, and postoperative care as well as drug compliance." @default.
• W4313454041 created "2023-01-06" @default.
• W4313454041 creator A5048416234 @default.
• W4313454041 creator A5053256738 @default.
• W4313454041 creator A5083208558 @default.
• W4313454041 date "2023-01-01" @default.
• W4313454041 modified "2023-10-18" @default.
• W4313454041 title "Commentary: Cataract surgery in pediatric patients with systemic comorbidities" @default.
• W4313454041 cites W1570276418 @default.
• W4313454041 cites W1995753939 @default.
• W4313454041 cites W2110429485 @default.
• W4313454041 cites W2163393580 @default.
• W4313454041 cites W2339477488 @default.
• W4313454041 cites W2976661560 @default.
• W4313454041 cites W3048192073 @default.
• W4313454041 cites W4246678320 @default.
• W4313454041 cites W4291511129 @default.
• W4313454041 cites W4313454770 @default.
• W4313454041 doi "https://doi.org/10.4103/ijo.ijo_2217_22" @default.
• W4313454041 hasPubMedId "https://pubmed.ncbi.nlm.nih.gov/36588223" @default.
• W4313454041 hasPublicationYear "2023" @default.
• W4313454041 type Work @default.
• W4313454041 citedByCount "0" @default.
• W4313454041 crossrefType "journal-article" @default.
• W4313454041 hasAuthorship W4313454041A5048416234 @default.
• W4313454041 hasAuthorship W4313454041A5053256738 @default.
• W4313454041 hasAuthorship W4313454041A5083208558 @default.
• W4313454041 hasBestOaLocation W43134540411 @default.
• W4313454041 hasConcept C118487528 @default.
• W4313454041 hasConcept C118552586 @default.
• W4313454041 hasConcept C126322002 @default.
• W4313454041 hasConcept C137627325 @default.
• W4313454041 hasConcept C141071460 @default.
• W4313454041 hasConcept C150966472 @default.
• W4313454041 hasConcept C187212893 @default.
• W4313454041 hasConcept C2775888743 @default.
• W4313454041 hasConcept C2780225610 @default.
• W4313454041 hasConcept C71924100 @default.
• W4313454041 hasConceptScore W4313454041C118487528 @default.
• W4313454041 hasConceptScore W4313454041C118552586 @default.
• W4313454041 hasConceptScore W4313454041C126322002 @default.
• W4313454041 hasConceptScore W4313454041C137627325 @default.
• W4313454041 hasConceptScore W4313454041C141071460 @default.
• W4313454041 hasConceptScore W4313454041C150966472 @default.
• W4313454041 hasConceptScore W4313454041C187212893 @default.
• W4313454041 hasConceptScore W4313454041C2775888743 @default.
• W4313454041 hasConceptScore W4313454041C2780225610 @default.
• W4313454041 hasConceptScore W4313454041C71924100 @default.
• W4313454041 hasIssue "1" @default.
• W4313454041 hasLocation W43134540411 @default.
• W4313454041 hasLocation W43134540412 @default.
• W4313454041 hasLocation W43134540413 @default.
• W4313454041 hasLocation W43134540414 @default.
• W4313454041 hasOpenAccess W4313454041 @default.
• W4313454041 hasPrimaryLocation W43134540411 @default.
• W4313454041 hasRelatedWork W1608152088 @default.
• W4313454041 hasRelatedWork W1966653791 @default.
• W4313454041 hasRelatedWork W2019636120 @default.
• W4313454041 hasRelatedWork W2309610076 @default.
• W4313454041 hasRelatedWork W2412965123 @default.
• W4313454041 hasRelatedWork W2460592364 @default.
• W4313454041 hasRelatedWork W2465854091 @default.
• W4313454041 hasRelatedWork W3002986063 @default.
• W4313454041 hasRelatedWork W3170389518 @default.
• W4313454041 hasRelatedWork W4322705554 @default.
• W4313454041 hasVolume "71" @default.
• W4313454041 isParatext "false" @default.
• W4313454041 isRetracted "false" @default.
• W4313454041 workType "article" @default.