title: Visual axis opacification after AcrySof intraocular lens implantation in children.
abstract: OBJECTIVE
  To evaluate visual axis opacification after AcrySof intraocular lens (IOL) (Alcon) implantation in pediatric eyes.
  
  
  METHODS
  Iladevi Cataract and IOL Research Centre, Ahmedabad, India.
  
  
  METHODS
  This prospective study evaluated 103 consecutive eyes of 72 children with congenital cataract. Two groups were formed based on age at surgery: Group 1, younger than 2 years, and Group 2, older than 2 years. All eyes in Group 1 (n = 37) had primary posterior continuous curvilinear capsulorhexis (PCCC) with anterior vitrectomy. In Group 2 (n = 66), management of the posterior capsule was assigned randomly to no PCCC (Group 2A, n = 37) or PCCC (Group 2B, n = 29). The PCCC group was further randomized into 2 subgroups: no vitrectomy (Group 2BN, n = 14) or vitrectomy (Group 2BV, n = 15). The primary outcome measures were visual axis opacification and the resulting need for a secondary procedure. Statistical analysis was performed using SPSS for Windows (version 11.0.1).
  
  
  RESULTS
  The mean age of the patients was 5.2 years +/- 5.0 (SD) (range 0.2 to 16.0 years) and the mean follow-up, 2.3 +/- 0.9 years (range 1.0 to 4.0 years). Overall, 41 eyes (39.8%) developed visual axis opacification and 14 (13.6%) required secondary intervention. In Group 1, 4 eyes (10.8%) developed visual axis opacification and 3 (8.1%) had a secondary pars plana vitrectomy. In Group 2A, 31 eyes (83.8%) developed posterior capsule opacification (PCO) and 10 eyes (27.7%) had secondary intervention. Children 8 years or younger at the time of surgery developed significantly greater PCO than older children (P =.01). Five eyes (37.5%) in Group 2BN had opacification of the anterior vitreous face, 1 of which required a secondary procedure. One eye (6.7%) in Group 2BV had visual axis opacification that did not require a secondary procedure.
  
  
  CONCLUSIONS
  AcrySof IOL implantation with appropriate management of the posterior capsule maintained a clear visual axis in 60.2% of eyes. Of the 39.8% of eyes with visual axis opacification, 13.6% had visually significant opacification and required a secondary procedure.
authors.affiliation: Iladevi Cataract and IOL Research Centre, Ahmedabad, India. shailad1@sancharnet.in
authors.forename: Abhay R
authors.initials: AR
authors.lastname: Vasavada
authors.forename: Rupal H
authors.initials: RH
authors.lastname: Trivedi
authors.forename: Vandana C
authors.initials: VC
authors.lastname: Nath
mesh_terms: D000180:Acrylic Resins / Q000009:adverse effects*; D000293:Adolescent; D019923:Capsulorhexis; D002386:Cataract / Q000151:congenital / Q000209:etiology*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D007903:Lens Capsule, Crystalline / Q000473:pathology*; D019654:Lens Implantation, Intraocular / Q000009:adverse effects*; D007910:Lenses, Intraocular / Q000009:adverse effects*; D008297:Male; D011183:Postoperative Complications; D011446:Prospective Studies; D012086:Reoperation; D012307:Risk Factors; D014821:Vitrectomy
chemical_list: D000180:Acrylic Resins