British Journal of Ophthalmology 2006;90:1386-1389
EXTENDED REPORT
Refractive outcomes after cataract surgery with primary lens implantation in infants
1 West of England Eye Unit, Royal Devon and Exeter Hospital, Exeter, UK
2 Musgrove Park Hospital, Taunton, UK
Correspondence to:
Correspondence to:
J-S Barry
West of England Eye Unit, Royal Devon and Exeter Hospital, Barrack Road, Exeter EX2 5DW, UK; johnsbarry{at}doctors.org.uk
Aims: To show the refractive outcomes, accuracy of intraocular lens power selection, and visual outcomes and complications in infants undergoing cataract surgery.
Methods: The refraction (spherical equivalent) of 14 operated eyes in 8 children aged <1 year was plotted over time. Preoperative and final recorded visual acuities were assessed.
Results: The median follow-up was 37.25 months. The median initial postoperative refraction was +6.75 dioptres.
Conclusions: Refractive outcomes for each eye were not entirely predictable and were variable between infants. However, there was a consistent pattern in each infant who underwent bilateral surgery, with both eyes following a similar pattern of refractive change with time: a decreasing myopic shift was seen in 8 eyes, possibly demonstrating emmetropisation. The two unilateral cases appeared to show a linear myopic shift. 4 eyes in 2 patients did not follow a myopic shift curve and one of these patients showed an early trend towards increased hyperopia. Definite causes for this erratic refractive change were not identified. A postoperative refraction >4.5 dioptres avoided early onset myopia.
The range of difference between postoperative and predicted refraction using SRK-T was –2.85 to 2.97 dioptres.
Most of the visual results are encouraging compared with historical data in older children.
Abbreviations: EUA, examinations under anaesthetic; IOL, intraocular lens; POH, postoperative hyperopia; PORC, postoperative refractive change; SLM, secondary lens matter
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Br. J. Ophthalmol. 2006 90: 1333.
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