title: Secondary posterior chamber intraocular lens implantation in pediatric patients.
abstract: OBJECTIVE
  To report results of secondary posterior chamber intraocular lens (IOL) implantation in previously aphakic pediatric patients.
  
  
  METHODS
  In 19 pediatric patients, 19 aphakic eyes (11 after infantile and eight after traumatic cataract surgery) received secondary sulcus-fixated posterior chamber IOL implants.
  
  
  RESULTS
  Visual acuity of 20/40 or better was achieved with IOL implantation and overrefraction in three of 11 infantile (27%) and six of eight traumatic cataract patients (mean follow-ups, 18.1 months [range, 8 to 29 months] and 18.0 months [range, 6 to 28 months]), respectively. Eighteen of 19 patients (95%) demonstrated postoperative vision equal to or better than preoperative levels; 15 of 19 patients (79%) showed improved vision after IOL implantation. The mean +/- SD difference between actual and predicted postoperative refraction at 1 month was -0.97 +/- 0.96 diopter. Average refractive error at last examination was -0.40 +/- 2.43 diopters. Amblyopia therapy was performed in 14 patients. One IOL required repositioning 8 months postoperatively. Strabismus was present in 14 patients before and 13 patients after IOL implantation, requiring surgery in four patients.
  
  
  CONCLUSIONS
  Secondary IOL implantation can be performed successfully in carefully selected pediatric patients. Visual acuity results are better in eyes with a history of traumatic cataract and are influenced by patient compliance. The short-term risks of the procedure appear no greater than those of primary IOL implantation, and complications resemble those seen in adults.
authors.affiliation: Duke University Eye Center, Durham, North Carolina 27710, USA.
authors.forename: J M
authors.initials: JM
authors.lastname: DeVaro
authors.forename: E G
authors.initials: EG
authors.lastname: Buckley
authors.forename: S
authors.initials: S
authors.lastname: Awner
authors.forename: J
authors.initials: J
authors.lastname: Seaber
mesh_terms: D002386:Cataract / Q000209:etiology; D002387:Cataract Extraction; D002648:Child; D002675:Child, Preschool; D005069:Evaluation Studies as Topic; D005131:Eye Injuries / Q000150:complications; D006801:Humans; D007223:Infant; D007910:Lenses, Intraocular; D011183:Postoperative Complications; D012086:Reoperation; D016896:Treatment Outcome; D014792:Visual Acuity