Rehabilitasi visual pasien katarak pediatrik dengan komplikasi post operasi: pupillary capture, membrane formation, PCO dan deprivation amblyopia

Abstract

INTRODUCTION : The prevalence of pediatric cataract that because blindness is around 1-15 per 10,000 children in developing countries such as Indonesia. Intraoperative difficulties and postoperative complications are still an obstacle. Therefore, we report the challenging of visual rehabilitation in pediatric cataract patient who were not routinely controlled and had postoperative complications.

CASE PRESENTATION : An 8-year-old child came with blurred vision on the right eye. Patient has had cataract extraction, primary posterior capsulotomy, anterior vitrectomy and peripheral iridectomy on the right eye (RE) and left eye (LE) in 2015, visual acuity (VA) improved after postoperative becomes 6/48 on the RE and 6/19 on the LE. After 2.5 years lost to follow up, the patient control again with deteriorating VA 0.5/60 on the RE. The RE pupil has a not round shape and a membrane is formed. There is intraocular lens (IOL) on RE, but pinched in the pupil. Retina and choroid are within normal limits from ultrasound examination. The patient was diagnosed with RE Pseudophakia post cataract extraction with complications of pupillary capture, membrane formation, PCO, amblyopia. We performed visual rehabilitation with membranectomy, optic iridectomy and IOL repositioning on the RE.

CONCLUSION : It showed improvement of visual acuity on RE from 0.5/60 become 6/30 after visual rehabilitation. The key to success in patients with pediatric cataracts lies in compliance for routine control so that visual rehabilitation can be carried out as early as possible to prevent amblyopia.