Most congenital cataracts do not affect vision and therefore do not require special treatment. However, some children with severe congenital cataracts that have a greater impact on vision (e.g., total cataract, nuclear cataract, posterior subcapsular cataract) need to be detected early and treated with cataract surgery in a timely manner to avoid affecting the development of visual function in young children and leading to amblyopia and nystagmus.
Some congenital cataracts do not affect vision and generally rarely progress or progress very slowly and can be left untreated; if they do affect vision, the earlier they are detected, the better the treatment effect is, because early removal of cataracts can enable the retina of the affected children to be stimulated by light and images at an early stage, which is conducive to normal development; otherwise, they may cause amblyopia, and even after removal of cataracts, vision will not improve. The timing of cataract surgery is a key issue affecting the recovery of postoperative visual function and has long been controversial in the ophthalmology community. Most experts recommend cataract extraction within 6 weeks of birth and IOL implantation after 2 years of age to minimize the form deprivation of the visual development system and reduce postoperative visual axis area clouding. Postoperative reconstruction of visual function should be emphasized, which mainly includes the correction of postoperative refractive error, prevention of amblyopia, restoration of fusion function and stereo vision, etc., so as to improve the prognosis of visual function of the children to the greatest extent.
In conclusion, timely detection and treatment of cataract surgery, postoperative systematic refractive correction, amblyopia treatment and binocular visual function training are of great significance for the comprehensive treatment of congenital cataract.