Somasheila Murthy, MBBS, of Shantilal Sanghvi Eye Institute in Mumbai, India, spoke with Ophthalmology 360 at the AAO 2025 Annual Meeting about her session on performing cataract surgery in pediatric patients.
Question:
You led a course at AAO 2025 titled Pediatric Cataract Surgery in Special Situations. What are some highlights?
Somasheila Murthy, MBBS:
Our course is on pediatric cataract surgery in special situations, and in this course, we intend to cover various different situations or diseases under which you have pediatric cataracts, for example, in anterior segment, dysgenesis, or pediatric cataract, along with pediatric glaucoma, and also pediatric cataract with uveitis. These are some of the case situations that we’re going to handle in this course and teach.
Question:
The session covers challenges related to pediatric cataract surgery. Can you talk a bit about that?
Somasheila Murthy, MBBS:
Pediatric population is not just a mini adult, as many pediatricians often say. Pediatric cataract surgery is extremely important because if we don’t operate on the child fast enough, so what happens is that we are not providing a clear visual access, and this is a very crucial period of neuroplasticity where amblyopia can set in. It’s extremely important to ensure that we do an extremely good cataract surgery for the patients. That’s the importance of all clinicians to understand what are the problems that we can face… First of all, what are the various entities that cause a pediatric cataract, and what are the problems that we can face during surgery for these patients, and how do we tackle those problems? Postoperatively, how do we rehabilitate them visually?
Question:
What are some indicators or implications of these early onset cataracts?
Somasheila Murthy, MBBS:
In underdeveloped countries, one of the common cause for the development of congenital cataract is in maternal infections, especially rubella. We do see a lot of pediatric cataracts due to rubella. The second common cause could be due to various syndromic associations and also due to the anatomical disease that you can have in the eye, which includes PHPV or marfanoid kind of a cataract or microspherophakia. These are some of the common causes of congenital cataract or developmental cataract.
Some of the causes of acquired cataract can include trauma postoperative to glaucoma surgery or post-corneal transplantation surgery. In addition to that, can also have uveitis as a cause of cataract in these patients, certain drugs that the child may be on. These are some of the various causes of cataract formation in pediatrics.
Question:
What is the importance of educating clinicians on this topic?
Somasheila Murthy, MBBS:
The importance of early surgery, but then how to do the surgery, that’s also equally important. With this course, we hope that most clinicians will have a very good understanding of what are the preoperative considerations to be taken care of, how to ensure that the child gets the appropriate intraocular lens into the eye, or at what stage or at what age should we plan to place an intraocular lens in the eye. A very young patient, very young child, in fact, we don’t place an intraocular lens, in which case we go on to do a secondary intraocular lens implantation. One of our topics for this course is also placement of secondary intraocular lens implantation for the patient.
This is how we take our course through in terms of the various causes of cataract, as well as how to tackle these cataracts surgically, as well as how to implant intraocular lenses in a secondary situation.
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