title: Morphological and functional results of AcrySof intraocular lens implantation in children: prospective randomized study of age-related surgical management.
abstract: OBJECTIVE
  To evaluate the prevalence and severity of posterior capsule opacification (PCO) in pediatric eyes with a foldable acrylic AcrySof (Alcon) intraocular lens (IOL) and age-related surgical methods.
  
  
  METHODS
  Department of Ophthalmology, University of Vienna, Medical School, Vienna, Austria.
  
  
  METHODS
  This prospective randomized study comprised 50 eyes of 34 children aged between 2 and 16 years. Eyes of children between 2 and 5.9 years were consecutively randomized to Group 1a (primary posterior capsulotomy and anterior vitrectomy) or Group 1b (optic capture in addition). Eyes of children between 6 and 16 years were consecutively randomized to Group 2a (primary posterior capsulotomy without anterior vitrectomy), Group 2b (optic capture in addition), or Group 2c (in-the-bag IOL implantation without opening the posterior capsule). Main outcome parameters were the incidence and severity of PCO formation, early postoperative complications, pigmented cell deposits on the IOL surface, and cataract morphology.
  
  
  RESULTS
  The visual axis was clear at the last follow-up in all eyes in Groups 1a, 1b, 2a, and 2b except in 1 eye in Group 1a. Sixty-percent of eyes in Group 2c had PCO. The incidence of early postoperative complications was significantly higher in eyes that developed PCO than in those that maintained a clear visual axis. There was no evidence that cataract morphology influenced PCO rates.
  
  
  CONCLUSIONS
  The AcrySof IOL was well tolerated in pediatric eyes. Optic capture was not necessary to ensure a clear visual axis. Primary posterior capsulotomy should be performed in preschool and uncooperative children and in eyes expected to have relatively high postoperative inflammation. Implanting the AcrySof in the bag and leaving the posterior capsule intact is acceptable for school children and juveniles with isolated developmental cataract.
authors.affiliation: Department of Ophthalmology, University Hospital of Vienna, Vienna, Austria. andrea.muellner-eidenbock@akh-wein.ac.at
authors.forename: Andrea
authors.initials: A
authors.lastname: Müllner-Eidenböck
authors.forename: Michael
authors.initials: M
authors.lastname: Amon
authors.forename: Elisabeth
authors.initials: E
authors.lastname: Moser
authors.forename: Andreas
authors.initials: A
authors.lastname: Kruger
authors.forename: Claudette
authors.initials: C
authors.lastname: Abela
authors.forename: Yasmin
authors.initials: Y
authors.lastname: Schlemmer
authors.forename: Thomas
authors.initials: T
authors.lastname: Zidek
mesh_terms: D000180:Acrylic Resins; D000293:Adolescent; D001672:Biocompatible Materials; D002386:Cataract / Q000151:congenital; D002387:Cataract Extraction / Q000379:methods*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D015994:Incidence; D007903:Lens Capsule, Crystalline / Q000473:pathology*; D019654:Lens Implantation, Intraocular / Q000379:methods*; D007910:Lenses, Intraocular; D008297:Male; D011183:Postoperative Complications / Q000473:pathology* / Q000517:prevention & control; D011446:Prospective Studies; D014792:Visual Acuity / Q000502:physiology*; D014821:Vitrectomy
chemical_list: D000180:Acrylic Resins; D001672:Biocompatible Materials