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Refractive outcomes after cataract surgery with primary lens implantation in infants
  1. J-S Barry1,
  2. P Ewings2,
  3. C Gibbon1,
  4. A G Quinn1
  1. 1West of England Eye Unit, Royal Devon and Exeter Hospital, Exeter, UK
  2. 2Musgrove Park Hospital, Taunton, UK
  1. 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

Abstract

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.

  • EUA, examinations under anaesthetic
  • IOL, intraocular lens
  • POH, postoperative hyperopia
  • PORC, postoperative refractive change
  • SLM, secondary lens matter

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Footnotes

  • Published Online First 26 July 2006

  • Funding: None.

  • Competing interests: None declared.

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