Cataract extraction and primary hydrophobic acrylic intraocular lens implantation in infants.
OBJECTIVE
We sought to report the incidence of visual axis opacification and to evaluate the complication and reoperation rates after intraocular lens implantation in infants.


METHODS
Twenty-one infants (31 eyes) who had cataract extraction with primary hydrophobic acrylic IOL implantation between October 1996 and May 2002 were reviewed. Posterior capsule was left intact in 14 eyes (group A); posterior capsulorrhexis or capsulotomy with anterior vitrectomy was performed in 17 eyes (group B). Complication and reoperation rates were compared with an age-matched control group of 17 patients (33 eyes) who were left aphakic after pars plicata lensectomy. Mean follow-up period was 41 months (range, 22-75 months) in group A, 37 months (range, 10-75 months) in group B, and 52 months (range, 7-97 months) in the control group.


RESULTS
Mean age of the patients was 6.8 months (range, 3-10 months) in group A, 8.9 months (range, 3-18 months) in group B, and 4.9 months (range, 1-15 months) in the control group. Visual axis opacification was significantly higher in group A (86%) when compared with group B (17.6%; P < 0.0001). No significant difference was found in terms of pupillary irregularities and peripheral anterior synechiae formation between pseudophakic and aphakic group ( P = 0.43 and P = 0.306, respectively), whereas pigment dispersion and fibrinous reaction were significantly more common in the pseudophakic group ( P = 0.002). Serious complications, such as retinal detachment, pseudophakic bullous keratopathy, and secondary glaucoma, did not develop in any eye. Reoperation rate was significantly higher in group A (78%) when compared with group B (17%) and the control group (12%; P = 0.0011 and P < 0.0001, respectively).


CONCLUSIONS
Visual axis opacification requiring a reoperation was significantly more common in patients with an intact posterior capsule. To decrease the reoperation rate and maintain a clear visual axis, posterior capsulorrhexis with anterior vitrectomy should be performed. Even although early complications were quite frequent, serious late complications were not encountered in any eye. Therefore, under appropriate conditions, IOL implantation is a suitable alternative in infants.
Tuncer
Samuray
S
Department of Ophthalmology, Istanbul Faculty of Medicine, Turkey. sbtuncer@yahoo.com
Gucukoglu
Ahmet
A
Gozum
Nilufer
N
D000179:Acrylates; D016022:Case-Control Studies; D002386:Cataract / Q000453:epidemiology / Q000209:etiology; D002387:Cataract Extraction / Q000009:adverse effects; D004867:Equipment Design; D005260:Female; D006801:Humans; D015994:Incidence; D007223:Infant; D019654:Lens Implantation, Intraocular / Q000009:adverse effects; D007910:Lenses, Intraocular; D008297:Male; D011184:Postoperative Period; D012086:Reoperation; D012189:Retrospective Studies; D014792:Visual Acuity
D000179:Acrylates