Visual outcome and complications of bilateral intraocular lens implantation in children.
OBJECTIVE
To determine the safety and efficacy of bilateral intraocular lens (IOL) implantation in children.


METHODS
Tertiary referral pediatric ophthalmology department.


METHODS
This retrospective study comprised 13 children (26 eyes) who had bilateral cataract surgery with IOL implantation. Patients were divided into 2 groups: congenital cases, diagnosed during the first year of life, and developmental cases, diagnosed after 1 year of age. All patients had small incision phacoemulsification with primary implantation of a poly(methyl methacrylate) or a foldable acrylic IOL. Primary posterior capsulotomy was performed in 16 eyes (61.5%).


RESULTS
Age at surgery ranged from 1 week to just under 8 years. Seven patients (53.8%) had a systemic diagnosis: Down's syndrome (n = 4); developmental delay or cerebral atrophy (n = 3). Five children with systemic problems could not cooperate with formal vision testing; 2 could fix and follow bilaterally, and 3 had central, steady, and maintained vision bilaterally. In the congenital group, 37.5% of eyes attained a visual acuity of 20/20 and 87.5%, 20/120 or better. In the developmental group, formal vision testing was possible in 4 children. Five eyes (83.3%) attained a visual acuity of 20/40 or better. Thirteen eyes (50.0%) required posterior capsulotomy. Primary posterior capsulotomy reduced the incidence of posterior capsule opacification (PCO), but there was no correlation between PCO and IOL material. One patient developed glaucoma bilaterally.


CONCLUSIONS
Bilateral IOL implantation was safe and produced good visual results in children of all ages with bilateral cataract.
O'Keefe
M
M
Eye Department, The Childrens Hospital, Dublin, Ireland.
Mulvihill
A
A
Yeoh
P L
PL
D000180:Acrylic Resins; D001672:Biocompatible Materials; D002386:Cataract / Q000150:complications / Q000151:congenital; D002387:Cataract Extraction; D002648:Child; D005901:Glaucoma / Q000209:etiology; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007903:Lens Capsule, Crystalline / Q000473:pathology; D019654:Lens Implantation, Intraocular / Q000009:adverse effects / Q000295:instrumentation; D007910:Lenses, Intraocular; D008266:Macula Lutea / Q000473:pathology; D009216:Myopia / Q000209:etiology; D019904:Polymethyl Methacrylate; D011183:Postoperative Complications; D011379:Prognosis; D012029:Refraction, Ocular; D012164:Retinal Diseases / Q000209:etiology / Q000473:pathology; D012189:Retrospective Studies; D013285:Strabismus / Q000151:congenital / Q000601:surgery; D014792:Visual Acuity
D000180:Acrylic Resins; D001672:Biocompatible Materials; D019904:Polymethyl Methacrylate