ABSTRACT
Purpose: To study the long-term safety profile and visual outcomes of primary intraocular lens (IOL) implantation in infants <6 months of age. Methods: This was a retrospective observational study conducted at a tertiary eye care center in South India. Infants under 6 months meeting the selection criteria who underwent cataract surgery (lens aspiration, primary posterior capsulorhexis, and anterior vitrectomy) with primary IOL implantation between January 2008 and December 2011 and minimum 3-year follow-up were included. Patient demographics, serial refractions, visual acuity, complications, and associated amblyopia/strabismus were reviewed. Visual acuity, myopic shift, and complications were the outcome measures. Results: Sixty-nine eyes of 38 infants (31 bilateral; mean age: 4.6 months) were reviewed. Mean follow-up was 51 months (range: 36�). Median logMAR best-corrected visual acuity at the final visit was 0.74 (interquartile range [IQR]: 0.50�98) in eyes with bilateral cataracts and 0.87 (IQR: 0.60�14) in eyes with unilateral cataracts with an average myopic shift of 6.7 diopters over 4.2 years. Most common postoperative complication was visual axis opacification (VAO) (13 eyes, 18%), necessitating membranectomy followed by pigmentary IOL deposits (11 eyes, 15%), and IOL decentration and glaucoma in four eyes each (5.6%). Mixed linear effect model found no significant association of age, gender, laterality, and postoperative complications with final visual acuity (P ? 0.05). Eyes with unilateral cataracts had a greater myopic shift than bilateral cases (P = 0.03). Conclusion: Primary IOL implantation in infants <6 months is reasonably safe in appropriately selected infants. VAO was the most common postoperative complication, and a large myopic shift was observed.
ABSTRACT
@#AIM: To compare the visual results and postoperative complications of polymethylmethacrylate(PMMA)and hydrophobic acrylic intraocular lenses(IOLs)in children who underwent cataract extraction with primary IOL implantation.<p>METHODS:This retrospective study included 117 eyes of 63 children with bilateral pediatric cataract undergoing cataract surgery and primary IOL implantation. The patients were divided into two groups, Group I included 58 eyes of 30 patients with PMMA IOLs; Group II included 59 eyes of 33 patients with hydrophobic acrylic IOLs. The clinical features, refraction errors, best corrected visual acuity(BCVA)and surgical complications were compared between two groups.<p>RESULTS:The mean age at the time of surgery was 5.8(2-12)y and mean follow up period was 40.5(6-196)mo. Postoperatively, BCVA was ≥0.5 in 80 eyes(68.4%)and this was comparable in two groups. Visual axis opacification was seen in 28 eyes(48.3%)in Group I and 16 eyes(27.1%)in Group II and this difference was statistically significant(<i>P</i>=0.018). Postoperative IOL dislocation and posterior synechia formation were also noted. When all postoperative complications were considered, there were significantly less complications in the acrylic IOL group than PMMA IOL group(<i>P</i>=0.020).<p>CONCLUSION: Pediatric cataract surgery with primary IOL implantation is a safe procedure. Hydrophobic acrylic IOLs may lead to less postoperative complications compared to PMMA IOLs.