Congenital Cataracts: Classification and Association With Anterior Segment Abnormalities

We compared the anterior segment characteristics of congenital cataract (CC) patients with lens opacities in different locations and proposed a modified, simple CC category system.Cataractous eyes of CC patients were classified into four groups based on the locations of lens opacities shown in slit-lamp examinations and by a 3-dimensional anterior segment imaging system as follows: total, anterior, interior, and posterior cataracts. The mean keratometry value, corneal astigmatism (CA), central corneal thickness (CCT), and anterior chamber depth (ACD) of eyes in different groups were compared.We included a total of 428 CC patients. Half of the patients with an anterior cataract had the complication of a pupillary residual membrane. Among the patients with posterior lentiglobus cataracts, 90.38% had unilateral involvement. Patients with total, anterior, or interior cataracts had larger keratometry values than those with either posterior cataracts or clear lens. Congenital cataract patients had greater CA and CCT values than those with a clear lens. The largest CA was presented in patients with anterior cataracts, and the value decreased gradually with more posterior locations of lens opacities. Eyes with total and anterior cataracts had smaller ACDs, and eyes with interior and posterior cataracts had greater ACDs than eyes with a clear lens.Cataractous eyes in CC patients with lens opacities in different locations presented distinct anterior segment characteristics. The modified CC category system, based on the relationships among the locations of lens opacities and anterior segment characteristics, may be beneficial for CC diagnosis and treatment.