title: Visual Outcomes and Complications of Piggyback Intraocular Lens Implantation Compared to Aphakia for Infantile Cataract.
abstract: OBJECTIVE
  To evaluate the long-term visual outcomes and complications of the piggyback intraocular lens (IOL) implantation compared to aphakia for infantile cataract.
  
  
  METHODS
  In a comparative study from 1998 to 2007, piggyback IOL implantation (piggyback IOL group) was performed for 14 infants (23 eyes) with infantile cataract and 20 infants (32 eyes) who were aphakic (aphakia group) after infantile cataract surgery. Data were collected on logMAR visual acuity, and postoperative complications over a mean follow-up time of 6.2 ± 1.7 years and 5.8 ± 1.7 years.
  
  
  RESULTS
  The mean age at surgery was 7.5 ± 0.6 months and 6.0 ± 3.3 months for the piggyback and the aphakic group respectively (P > 0.05). At the last follow-up visit, visual acuity was 0.85 ± 0.73 (median = 0.70, interquartile range = 0.3-1.32) in the piggyback IOL group and 0.89 ± 0.56 (median = 0.86, interquartile range = 0.50-1.24) in the aphakic group (P > 0.05). There was a positive relationship between age and visual outcomes in the aphakic group (r = 0.4, P = 0.04) but not in the piggyback IOL group (P = 0.48). There was no significant difference between the mean myopic shift in the piggyback IOL group (-5.28 ± 1.06 D) and the aphakic group (-5.10 ± 1.02 D) (P > 0.05). The incidence of reoperation due to complications in piggyback IOL group was higher than aphakic group (%48 vs. %16, respectively, P ≤ 0.01). However, in patients older than 6 months, this risk was not significantly different compared to the aphakic group.
  
  
  CONCLUSIONS
  Although piggyback IOL implantation for infantile cataract is optically acceptable as a treatment option, there is no significant difference in visual outcomes compared to aphakia. The incidence in reoperation due to complications in patients aged 6 months or younger is higher than those treated with aphakia.
authors.affiliation: Eye Research Center, Rassoul Akram Hospital, Tehran, Iran.
authors.forename: Mahmood
authors.initials: M
authors.lastname: Joshaghani
authors.affiliation: Eye Research Center, Farabi Eye Hospital, Tehran, Iran.
authors.forename: Mohammad
authors.initials: M
authors.lastname: Soleimani
authors.affiliation: Eye Research Center, Rassoul Akram Hospital, Tehran, Iran.
authors.forename: Alireza
authors.initials: A
authors.lastname: Foroutan
authors.affiliation: Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.
authors.forename: Mehdi
authors.initials: M
authors.lastname: Yaseri
mesh_terms: D001036:Aphakia, Postcataract / Q000503:physiopathology*; D002386:Cataract / Q000151:congenital*; D002387:Cataract Extraction; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D019654:Lens Implantation, Intraocular / Q000009:adverse effects; D008297:Male; D011183:Postoperative Complications; D019591:Pseudophakia / Q000503:physiopathology*; D012086:Reoperation; D016896:Treatment Outcome; D014792:Visual Acuity / Q000502:physiology*
keywords: Aphakia; Cataract Extraction; Infant; Intraocular Lens; Piggyback Intraocular Lens; Postoperative Complications