Choice of lens and dioptric power in pediatric pseudophakia.
OBJECTIVE
To evaluate lens choice and dioptric power in pediatric eyes having posterior chamber intraocular lens (IOL) implantation.


METHODS
Oxford Eye Center and the St. John Eye Hospital, Johannesburg, South Africa.


METHODS
This retrospective study evaluated the refractive development in 156 pseudophakic eyes of 99 children aged 1 month to 8 years who had surgery between June 1983 and April 1994. The children were divided into three groups based on age at time of IOL implantation: Group A (68 eyes), 1 to 18 months; Group B (32 eyes), 19 to 36 months; Group C (48 eyes), 3 to 8 years. Poly(methyl methacrylate) posterior chamber IOLs with an overall diameter between 10.5 and 12.0 mm were used. The dioptric power was 3.00 to 6.00 diopters (D) less than that needed to achieve emmetropia.


RESULTS
In Group A, the mean growth in axial length was 3.59 mm +/- 1.80 (SD) and the mean change in refraction was 6.39 +/- 3.68 D. In Group B, the respective means were 0.75 +/- 0.85 mm and 2.73 +/- 1.40 D and in Group C, 0.76 +/- 0.69 mm and 2.60 +/- 1.84 D.


CONCLUSIONS
The younger the child at time of implantation, the greater the myopic shift. To reduce the necessity of IOL exchange, these eyes should be undercorrected, with the residual refractive error corrected by spectacles that are adjusted throughout life according to refractive development. This leads to initial hypermetropia that gradually moves to emmetropia or moderate myopia in adulthood.
Dahan
E
E
St. John Eye Hospital, Johannesburg, South Africa.
Drusedau
M U
MU
D002386:Cataract / Q000151:congenital / Q000503:physiopathology; D002387:Cataract Extraction; D002648:Child; D002675:Child, Preschool; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D007910:Lenses, Intraocular; D020366:Methylmethacrylate; D008768:Methylmethacrylates; D055095:Optics and Photonics; D010818:Practice Patterns, Physicians'; D012030:Refractive Errors / Q000503:physiopathology; D012189:Retrospective Studies; D014792:Visual Acuity
D008768:Methylmethacrylates; D020366:Methylmethacrylate