Ocular wavefront aberrometry as an adjunct in surgical decision-making for pediatric posterior polar cataract with posterior lenticonus: a case report

This report presents a 5-year-old boy with unilateral congenital cataract and posterior lenticonus, where wavefront aberrometry objectively quantified lenticular aberrations to resolve surgical timing uncertainty. Despite 0.3 corrected visual acuity and paracentral opacity, iTrace analysis revealed severe intraocular aberrations (high-order aberrations = 1.426 μm, dysfunctional lens index = 0.34,) uncorrectable with spectacles or mydriasis. One month following phacoemulsification with primary IOL implantation, the best-corrected visual acuity (BCVA) improved from 0.3 to 0.8. Aberrometry provides critical functional data to supplement morphological assessment in borderline pediatric cataracts, optimizing developmental visual outcomes.