title: Congenital cataract extraction with primary aphakia and secondary intraocular lens implantation in the posterior chamber.
abstract: OBJECTIVE
  To evaluate visual outcomes, eye movement abnormalities, and postoperative complications after secondary posterior chamber intraocular lens (IOL) implantation in aphakic children who had initial LAC correction.
  
  
  METHODS
  A retrospective study was carried out on 53 patients (94 eyes). Following aphakic surgery and LAC correction the patients received secondary IOL implantation in the posterior chamber. Special attention was paid to factors that may have influenced their visual outcomes, such as eye movement abnormalities, cataract unilaterality, and cataract density.
  
  
  RESULTS
  No association was found between age at surgery and the onset of strabismus (p=0.611) or with visual acuity (p=0.086). However, unilaterality and total cataract density were found to have a negative association with poor vision (p<0.001). Strabismus and nystagmus were found to have a statistically significant negative association with visual acuity (p=0.002). Posterior capsule opacification occurred in six eyes of five patients following cataract extraction; IOL dislocation occurred in four eyes after IOL intraocular implantation, and secondary glaucoma occurred in one eye.
  
  
  CONCLUSIONS
  IOL implantation before 12 months of age may be useful in unilateral cataract; in bilateral cataract, simultaneous surgical aphakia, LAC correction, and then IOL implantation at 2.5-3 years of age, together with anti-amblyopic therapy when strabismus or asymmetric cataract density occur, are efficient methods to obtain visual recovery. Extraocular muscle surgery may be required to correct strabismus.
authors.affiliation: Department of Ophthalmology, University of Napoli Federico II, Napoli - Italy. magli@unina.it
authors.forename: A
authors.initials: A
authors.lastname: Magli
authors.forename: F
authors.initials: F
authors.lastname: Fimiani
authors.forename: D
authors.initials: D
authors.lastname: Bruzzese
authors.forename: R
authors.initials: R
authors.lastname: Carelli
authors.forename: U
authors.initials: U
authors.lastname: Giani
authors.forename: A
authors.initials: A
authors.lastname: Iovine
mesh_terms: D001036:Aphakia, Postcataract / Q000503:physiopathology / Q000601:surgery*; D002386:Cataract / Q000151:congenital*; D002387:Cataract Extraction; D002675:Child, Preschool; D005133:Eye Movements / Q000502:physiology; D005260:Female; D006801:Humans; D007223:Infant; D019654:Lens Implantation, Intraocular / Q000379:methods*; D008297:Male; D009759:Nystagmus, Pathologic / Q000503:physiopathology; D011183:Postoperative Complications; D012189:Retrospective Studies; D013285:Strabismus / Q000503:physiopathology; D014792:Visual Acuity / Q000502:physiology