title: Pediatric intraocular lens implantation. Surgical results and complications in more than 300 patients.
abstract: OBJECTIVE
  The study aimed to review pediatric intraocular lens (IOL) implantations performed in the authors' institution for the past 7 years.
  
  
  METHODS
  The study design was a retrospective chart review.
  
  
  METHODS
  All children who underwent IOL placement between January 1, 1989, and January 31, 1996, at ages 2 to 16 years were studied. Follow-up was a minimum of 6 months up to 4 years with an average of 13 months.
  
  
  METHODS
  Placement of a primary or secondary posterior chamber IOL was performed.
  
  
  METHODS
  Visual acuity and possible complications were tabulated.
  
  
  RESULTS
  Fifty-seven percent of the cataracts were caused by trauma, and 37% were infantile cataracts. Visual acuities of 20/40 or better were attained in 44% of eyes and visual acuities of 20/50 to 20/80 were attained in 27% of eyes. Visual acuities were better in children older than 4 years of age (P = 0.001). Compliance with amblyopia therapy improved vision (P = 0.004). Fibrinous membranes occurred in 41 eyes (13%), and posterior capsule opacification occurred in 120 eyes (39%). There were no significant differences in visual outcome and complications between primary and secondary implants (17%) or between capsular bag and sulcus fixation (27%). The first stable postoperative refraction was predicted accurately in most patients, based on the Sanders-Retzlaff-Kraff II (SRK II) formula and intraoperative corneal curvature and axial length determinations. The mean refraction differed from the goal by only +0.28 diopter and 84% were within +/- 2 diopters. A few patients showed large overcorrections or undercorrections. On average, no myopic shift occurred.
  
  
  CONCLUSIONS
  Short-term results of IOLs implanted in children older than 2 years of age were favorable. Visual acuities obtained were better than 20/80 in 71% despite a high prevalence (28%) of penetrating trauma. Major complications were rare.
authors.affiliation: Division of Pediatric Ophthalmology, King Khaled Eye Specialist Hospital, Riyadh, Kingdom of Saudi Arabia.
authors.forename: J
authors.initials: J
authors.lastname: Zwaan
authors.forename: P B
authors.initials: PB
authors.lastname: Mullaney
authors.forename: A
authors.initials: A
authors.lastname: Awad
authors.forename: S
authors.initials: S
authors.lastname: al-Mesfer
authors.forename: D T
authors.initials: DT
authors.lastname: Wheeler
mesh_terms: D000293:Adolescent; D002386:Cataract / Q000151:congenital / Q000209:etiology; D002387:Cataract Extraction; D002648:Child; D002675:Child, Preschool; D015807:Eye Injuries, Penetrating / Q000150:complications / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D019654:Lens Implantation, Intraocular; D007908:Lens, Crystalline / Q000293:injuries; D008297:Male; D011183:Postoperative Complications; D012029:Refraction, Ocular; D012189:Retrospective Studies; D016896:Treatment Outcome; D014792:Visual Acuity / Q000502:physiology*