Outcome of lens aspiration and intraocular lens implantation in children aged 5 years and under.
OBJECTIVE
To determine the visual outcome and complications of lens aspiration with intraocular lens implantation in children aged 5 years and under.


METHODS
The hospital notes of all children aged 5 years and under, who had undergone lens aspiration with intraocular lens implantation between January 1994 and September 1998, and for whom follow up data of at least 1 year were available, were reviewed.


RESULTS
Of 50 children who underwent surgery, 45 were eligible based on the follow up criteria. 34 children had bilateral cataracts and, of these, 30 had surgery on both eyes. Cataract was unilateral in 11 cases; thus, 75 eyes of 45 children had surgery. Cataracts were congenital in 28 cases, juvenile in 16, and traumatic in one case. The median age at surgery was 39 months (range 11-70 months). Follow up ranged from 12-64 months (median 36 months). Of 34 children with bilateral disease, 25 (73.5%) had a final best corrected visual acuity of 6/12 or better, while seven (20.5%) achieved 6/18 or less; in one child the vision improved from UCUSUM to CSM but another, who had only one eye operated on, was unable to fix or follow with this eye preoperatively or 2 years postoperatively. Of 11 children with unilateral cataract, five (45.5%) had a final best corrected visual of 6/12 or better, and six (54.5%) 6/18 or less. A mild fibrinous uveitis occurred in 20 (28.2%) eyes in the immediate postoperative period, but resolved with topical steroids. One child had a vitreous wick postoperatively requiring surgical division. Glaucoma, endophthalmitis, or retinal detachment have not been observed so far in any patient postoperatively.


CONCLUSIONS
From this series the authors suggest that, in children aged 5 years and under, lens aspiration with intraocular lens implantation is a safe procedure, with a good visual outcome in the short term. Further studies are needed to investigate these outcomes in the long term.
Cassidy
L
L
Department of Ophthalmology, Great Ormond Street Hospital for Children, Great Ormond Street, London.
Rahi
J
J
Nischal
K
K
Russell-Eggitt
I
I
Taylor
D
D
D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D002386:Cataract / Q000209:etiology; D002387:Cataract Extraction / Q000379:methods*; D002675:Child, Preschool; D003907:Dexamethasone / Q000627:therapeutic use; D005260:Female; D005403:Fixation, Ocular / Q000502:physiology; D006801:Humans; D007223:Infant; D019654:Lens Implantation, Intraocular / Q000379:methods*; D008297:Male; D010349:Patient Compliance; D011183:Postoperative Complications / Q000628:therapy*; D012189:Retrospective Studies; D016896:Treatment Outcome; D014792:Visual Acuity
D000893:Anti-Inflammatory Agents; D003907:Dexamethasone