Pediatric intraocular lens implantation. Surgical results and complications in more than 300 patients.
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.
Zwaan
J
J
Division of Pediatric Ophthalmology, King Khaled Eye Specialist Hospital, Riyadh, Kingdom of Saudi Arabia.
Mullaney
P B
PB
Awad
A
A
al-Mesfer
S
S
Wheeler
D T
DT
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*