SURGERY OF CONGENITAL CATARACT - 24TH JACKSON,E MEMORIAL LECTURE

A series of 132 eyes operated on for congenital cataract are reported. The following operations were employed: 1. 1. Simple discission without iridotomy or iridectomy. 2. 2. Linear extraction with sector iridectomy. 3. 3. Linear extraction with sector iridectomy plus inferior iridotomy. 4. 4. Linear extraction with sector iridectomy, inferior iridotomy and two peripheral iridectomies. 5. 5. Linear extraction with sector iridectomy, two peripheral iridectomies and sphincterotomy at the 3-, 6-, and 9-o'clock meridians. In older children with lamellar cataract, the results were excellent regardless of the type of operation employed. In the case of infants and very young children, if simple discission or linear extraction with sector iridectomy were done, a number of eyes were lost. In the cases in which linear extraction with sector iridectomy and inferior iridotomy and two peripheral iridectomies, linear extraction with sector iridectomy, two peripheral iridectomies and sphincterotomy at the 3-, 6-, and 9-o'clock meridians were done, the results were much better, with the highest percentage of success with the last type of operation. The principal cause of loss of an eye after congenital cataract surgery is pupillary block leading to peripheral anterior synechias and intractable glaucoma. The impressive widening of the pupil in all directions provided by linear extraction with sector iridectomy, sphincterotomy at the 3-, 6-, and 9- o'clock meridians, plus two peripheral iridectomies, appear to minimize the risk of pupillary block and thus far has given the highest percentage of success. © 1968.