Anterior and Posterior Subcapsular and Polar Cataracts

Abstract

Listen

Translate article

Anterior and posterior polar cataracts are unique in that they are usually congenital, resulting from an abnormality during embryogenesis. Anterior polar cataracts can be present at birth and if small may not cause significant problems to impact vision; however, they may progress and become more significant with age, or when extrinsic factors such as trauma or inflammation occur. Posterior polar cataracts can also be small and not significantly impair vision during childhood but may mature to impact vision with age. While anterior polar cataracts can be treated effectively with surgery due to the ease of their access at the front of the lens, posterior polar cataract may be more challenging surgically due to its common adherence to the posterior capsule, sometimes with a posterior capsule defect. In contrast to the polar cataracts, posterior and anterior subcapsular cataracts are usually acquired. Posterior subcapsular cataracts may be associated with factors such as topical and systemic steroid use and high alcohol intake, while anterior subcapsular cataracts are commonly associated with atopy. This chapter describes these different types of cataracts, their formation and causation, along with specific surgical approaches that can help achieve a favorable outcome.