title: Long-Term Visual Outcomes of Secondary Intraocular Lens Implantation in Children with Congenital Cataracts.
abstract: OBJECTIVE
  The aim of this study was to evaluate the long-term visual outcomes and factors affecting visual results in children undergoing secondary intraocular lens (IOL) implantation following primary congenital cataract extraction.
  
  
  METHODS
  Children with congenital cataracts who underwent secondary IOL implantation for aphakia at the Eye and ENT Hospital of Fudan University between January 1, 2001, and December 31, 2007, were retrospectively reviewed. One eye was randomly selected in children with bilateral cataracts. Laterality, type of cataract (total or partial opacity), sex, age at primary and secondary surgeries, visual axis opacity (VAO), compliance with amblyopia therapy, postoperative ocular complications, refractive error, ocular alignment, and best corrected visual acuity (BCVA) at last follow-up were recorded; potential factors that might have affected the visual results were evaluated.
  
  
  RESULTS
  Seventy-six bilateral and 34 unilateral congenital cataract cases were analyzed; the mean ages of the children were 12.70±5.06 and 12.50±2.71 years at final follow-up, the mean follow-up periods from IOL implantation were 94.93±24.22 and 109.09±18.89 months, and the mean BCVA (Log MAR) values were 0.51±0.37 and 1.05±0.46, respectively. Final BCVA after secondary IOL implantation was significantly associated with laterality, type of cataract, age at primary cataract extraction, compliance with amblyopia therapy, and refractive correction after surgery. No significant associations were found between BCVA and sex, age at secondary IOL implantation, VAO, or other ocular complications. The most common ocular complications were VAO and elevated intraocular pressure after surgery. There were no other complications, with the exception of one eye with IOL dislocation.
  
  
  CONCLUSIONS
  The results indicate that the important determinants of long-term visual outcomes in children with congenital cataracts undergoing secondary IOL implantation are laterality, cataract type, age at initial cataract extraction, compliance with amblyopia therapy, and refractive error.
authors.affiliation: Department of Ophthalmology and Vision Science, Eye and ENT Hospital of Fudan University, Shanghai, China; Key Laboratory of Myopia of State Health Ministry, and Key Laboratory of Visual Impairment and Restoration of Shanghai, Shanghai, China.
authors.forename: Xianfang
authors.initials: X
authors.lastname: Rong
authors.affiliation: Department of Ophthalmology and Vision Science, Eye and ENT Hospital of Fudan University, Shanghai, China; Key Laboratory of Myopia of State Health Ministry, and Key Laboratory of Visual Impairment and Restoration of Shanghai, Shanghai, China.
authors.forename: Yinghong
authors.initials: Y
authors.lastname: Ji
authors.affiliation: Department of Ophthalmology and Vision Science, Eye and ENT Hospital of Fudan University, Shanghai, China; Key Laboratory of Myopia of State Health Ministry, and Key Laboratory of Visual Impairment and Restoration of Shanghai, Shanghai, China.
authors.forename: Yanwen
authors.initials: Y
authors.lastname: Fang
authors.affiliation: Department of Ophthalmology and Vision Science, Eye and ENT Hospital of Fudan University, Shanghai, China; Key Laboratory of Myopia of State Health Ministry, and Key Laboratory of Visual Impairment and Restoration of Shanghai, Shanghai, China.
authors.forename: Yongxiang
authors.initials: Y
authors.lastname: Jiang
authors.affiliation: Department of Ophthalmology and Vision Science, Eye and ENT Hospital of Fudan University, Shanghai, China; Key Laboratory of Myopia of State Health Ministry, and Key Laboratory of Visual Impairment and Restoration of Shanghai, Shanghai, China.
authors.forename: Yi
authors.initials: Y
authors.lastname: Lu
mesh_terms: D000293:Adolescent; D002386:Cataract / Q000151:congenital* / Q000503:physiopathology; D002387:Cataract Extraction; D002648:Child; D005260:Female; D006801:Humans; D019654:Lens Implantation, Intraocular; D008297:Male; D012189:Retrospective Studies; D014792:Visual Acuity