Primary intraocular lens implantation in the first two years of life: safety profile and visual results.
OBJECTIVE
To study the safety profile of primary intraocular lens (IOL) implantation in the first two years of life.


METHODS
A prospective nonrandomized, interventional study was done at the tertiary care center. Forty-five eyes of 27 children (aged three weeks to two years) with congenital cataract who underwent phacoaspiration with continuous curvilinear capsulorrhexis combined with primary posterior capsulotomy and anterior vitrectomy with in the bag placement of IOL at primary surgery were included. Outcome measures were clarity of visual axis, postoperative inflammation, fixation pattern and retinoscopy.


RESULTS
The mean IOL power was 23.95 +/- 0.87 diopter (D) (range 22D to 27D). Follow-up ranged from 12 months to 48 months (mean 18 +/- 9.13 months). In infants, hypermetropia decreased from 6.60D +/- 2.64D at one week postoperatively to 3.03D +/- 2.53D at one year following surgery and 4.78D +/- 1.93D to 2.56D +/- 1.5D in children older than one year at the time of surgery. Re-opacification of the central visual axis was observed in six eyes (13.3%). Significant posterior synechiae due to irido-capsular adhesion was seen in seven eyes (15.6%). Five of these seven eyes also had significant posterior capsular opacification.


CONCLUSIONS
Meticulously performed primary IOL implantation and primary posterior capsulorrhexis with anterior vitrectomy in the first two years of life is a safe and effective method of aphakic correction.
Ram
Jagat
J
Department of Ophthalmology, Postgraduate Institute of Medical Education and Research, Chandigarh, India. jagatrampgi@yahoo.co.in
Brar
Gagandeep Singh
GS
Kaushik
Sushmita
S
Sukhija
Jaspreet
J
Bandyopadhyay
Supratik
S
Gupta
Amod
A
D019923:Capsulorhexis; D002386:Cataract / Q000151:congenital*; D002387:Cataract Extraction; D005260:Female; D006801:Humans; D006956:Hyperopia / Q000209:etiology / Q000503:physiopathology; D007223:Infant; D007231:Infant, Newborn; D019654:Lens Implantation, Intraocular / Q000009:adverse effects; D008297:Male; D011184:Postoperative Period; D011446:Prospective Studies; D012008:Recurrence; D013997:Time Factors; D016896:Treatment Outcome; D014785:Vision, Ocular; D014821:Vitrectomy