Changes in refraction and ocular dimensions after cataract surgery and primary intraocular lens implantation in infants
Accepted 17 January 2006.
Purpose
To study refraction and axial length changes after cataract extraction and primary intraocular lens (IOL) implantation in children younger than 1 year of age.
Setting
Two regional hospitals.
Methods
After determining the IOL power for emmetropia, 80% of the value was used to choose the IOL for implantation to counter anticipated myopic shift with age. The main outcome measures were changes in refraction and axial length 3 years after surgery.
Results
Thirty-four eyes of 20 children (mean age 6.7 months ± 3.9 [SD]) were studied. Refraction in the immediate postoperative period was +4.53 ± 1.45 diopters (D). Three years after surgery, the mean refraction was −2.49 ± 3.08 D (P<.001). Twenty-two eyes (64.7%) had surgery during the first 6 months of life (group 1) and had a shorter axial length at surgery (mean 18.92 ± 1.32 mm) compared with 12 eyes (35.3%) that received surgery between 7 and 12 months (group 2, mean 20.29 ± 1.00 mm) (P = .007). However, the final axial length was greater in group 1 (mean 22.67 ± 1.04 mm) than in group 2 (mean 21.23 ± 0.26 mm) (P = .019).
Conclusions
Primary IOL implantation is an option for children having cataract surgery in the first year of life. Significant myopic shifts occurred, and this seemed to be more pronounced in younger children. It appears that rethinking current strategies for IOL power calculation may be required to achieve more optimal refractive outcomes.
From the Department of Ophthalmology and Visual Sciences (Fan, Rao, Lam), The Chinese University of Hong Kong, Hong Kong Eye Hospital, Kowloon, Hospital Authority Ophthalmic Service (Yu), Hong Kong Eye Hospital, Kowloon, and Department of Ophthalmology & Visual Sciences (Wong), The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong, China
Reprint requests to Dennis S. C. Lam, FRCS, FRCOphth, Chairman and Professor, Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong Eye Hospital, 147K Argyle Street, Kowloon, Hong Kong, China.
Supported in part by the Action for Vision Foundation.
No author has a financial or proprietary interest in any material or method mentioned.
ABSTRACT