Clinical features of strabismus and nystagmus in bilateral congenital cataract

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PurposeThe prevalence and clinical features of strabismus and nystagmus, and the factors affecting onset of strabismus and nystagmus were evaluated in the patients with bilateral congenital cataract.Methods58 patients, 116 eyes who had lens removal for the treatment of bilateral congenital cataract between January 1999 and January 2011 were evaluated. According to the preoperative and postoperative ocular alignment, patients were divided into 3 groups (Orthotropia/Orthotropia, Orthotropia/Strabismus, and Strabismus/Strabismus). Age at cataract surgery, and associations of nystagmus and primary intraocular lens (IOL) implantation with strabismus were analyzed.Results6 patients (10.3%) had strabismus preoperatively and 11 patients (19.0%) developed postoperative strabismus. Thus, total 17 patients (29.3%) had strabismus postoperatively. Exotropia was more common than esotropia both preoperatively and postoperatively. 18 patients (31.0%) had nystagmus postoperatively and sensory nystagmus was the most common type. Of the 18 patients with nystagmus, 10 patients had strabismus and exotropia was more common than esotropia. When there was nystagmus, postoperative visual acuity was poor. In the ortho/strabismus group, age at cataract sugery was significantly younger and postoperative nystagmus was more common and the rate of no primaryIOLimplantation was higher than the other groups.ConclusionsIn patients with bilateral congenital cataracts, exotropia and sensory nystagmus may be common. Age at surgery was earlier, the rate of noIOLimplantation was higher and nystagmus was more common in postoperative strabismus onset group. And if there is nystagmus, poor visual prognosis may be seen. Therefore, careful observation should be needed in these patients.