Refractive Change and Complications Following Single or Temporary Piggyback Intraocular Lens Implantation in Infancy

ABSTRACT

PURPOSE: The purpose of this study was to assess the incidence of postoperative complications and the change of refractive error in infantile eyes after cataract surgery and single intraocular lens(IOL) or temporary piggyback IOL implantation. METHODS: Eight consecutive patients (13 eyes) who underwent IOL implantation under 12 months of age between 1999 and 2002 were enrolled. Eight eyes of 6 patients had a single IOL implanted and the other 5 eyes of 3 patients underwent temporary piggyback IOL implantations. A retrospective chart review was conducted. RESULTS: The mean age at surgery was 6.1 months. The mean follow-up period was 10 months. The average postoperative refraction at one week was +7.82D after single IOL and +0.32D after piggyback IOL. The average postoperative refraction at last follow-up was +4.25D and -3.5D respectively. Over the follow-up period, the mean refractive change per months was -0.34D in the single IOL group and -0.45D in the piggyback IOL group. Postoperative complications were 12.5 % (1/8 eyes) in single IOL and 20.0% (1/5 eyes) in piggyback IOL. Reoperations were conducted for the complicated eyes in both groups. CONCLUSIONS: The rates of complications and reoperations were slightly higher in piggyback IOL than in single IOL. Nonetheless, additive correction for residual hyperopia was not needed in the piggyback IOL group. There was more deteriorative evidence of amblyopia in piggyback IOL than in single IOL.