DIABETIC CATARACT IN CHILDREN

Purpose and methods: Adolescent patients with insulin-dependent diabet es mellitus (IDDM) were retrospectively analyzed for the occurrence an d possible predisposing factors of diabetic cataract in a population-b ased series of some 600 pediatric diabetics followed up during the Yea rs 1975-1995. Results: Six patients (1%) needed cataract surgery, At t he diagnosis of cataract they were 9.1-17.5 years old, and the duratio n of diabetes was between 0 months and 3 years 11 months, The type of cataract nas similar in all patients characterized by bilateral snowfl ake type cortical deposits and posterior subcapsular cataract. Four of the st patients had at least a st-month history of diabetic symptoms before the treatment was started, and five patients had ketoacidosis a t initial admission to hospital. In one of the 11 operated eyes diabet ic retinopathy was observed immediately after surgery Three patients d eveloped proliferative retinopathy within 7-10 months after the operat ion, after 6.3-11.8 years of diabetes. Conclusions: The prevalence of diabetic cataract was around 1% in the pediatric diabetic population. In the pathogenesis of cataract long duration of diabetic symptoms and ketoacidosis prior to the commencement of treatment may be of signifi cance. Good metabolic control after diagnosis did not protect for cata ract. Diabetic cataract can safely be treated by modern surgical techn iques, but close monitoring of the fundi for retinopathy after the ope ration is crucial, as proliferative retinopathy may develop rapidly af ter cataract surgery despite relatively short duration and acceptable metabolic control of diabetes.