Refractive outcomes with secondary intraocular lens implantation in children.
OBJECTIVE
To determine the accuracy of postoperative predicted refractive outcomes in surgically aphakic pediatric patients undergoing secondary intraocular lens (IOL) implantation. Comparisons were also made with other variables historically considered important in cataract surgery.


METHODS
Retrospective review of 50 eyes from 35 consecutive pediatric patients (< or =18 years of age) undergoing secondary IOL implantation within the ciliary sulcus or posterior capsular bag. All cases were performed by 1 of 2 surgeons and all refractions were performed manually using the retinoscope by an experienced pediatric ophthalmologist.


RESULTS
The mean patient age at the time of the secondary implantation was 6.5 years of age (range, 0.58-15.04). The mean patient age at the time of the primary cataract extraction was 0.78 years (range, 0.08-5.77). For all patients, mean absolute value of prediction error was 1.64 D (SD 1.58 D). There were no significant associations between mean absolute value of prediction error and any of the variables measured including axial length, corneal mean curvature, bag or sulcus implantation, formula used, or age at primary and secondary surgery (p > 0.05).


CONCLUSIONS
The mean absolute value of prediction error observed in this study is consistent with previous pediatric primary and secondary IOL data in that it shows a considerable difference from that expected in adult populations. Our findings support the argument that methods currently employed to calculate IOL power may fail to accurately account for all the variations in the eyes of pediatric patients.
Moore
Daniel B
DB
University of Washington School of Medicine, Seattle, Washington.
Ben Zion
Itay
I
Neely
Daniel E
DE
Roberts
Gavin J
GJ
Sprunger
Derek T
DT
Plager
David A
DA
D000293:Adolescent; D001036:Aphakia, Postcataract / Q000503:physiopathology / Q000601:surgery*; D002386:Cataract / Q000151:congenital; D002387:Cataract Extraction; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D019654:Lens Implantation, Intraocular; D008297:Male; D019591:Pseudophakia / Q000503:physiopathology*; D012029:Refraction, Ocular / Q000502:physiology*; D012030:Refractive Errors / Q000503:physiopathology*; D042262:Retinoscopy; D012189:Retrospective Studies