Refractive outcomes following primary intraocular lens implantation in infants

Abstract

Background/Aims: Intraocular lens implantation is becoming increasingly accepted as a primary procedure in infants. This study aimed to evaluate the accuracy of intraocular lens power calculation, the rate of myopic shift and the refractive outcome following primary intraocular lens implantation in infants less than 12 months old at the time of cataract surgery.

Method: A retrospective case review of 25 patients (8 with bilateral cataracts and 17 with unilateral) who underwent cataract surgery with primary intraocular lens implantation at less than 12 months old. Outcomes measured were actual early post-operative refraction, lens power calculation error, myopic shift and refractive outcome.

Results: Actual post-operative refraction was within 2 dioptres of the target refraction in 83% of cases. Lens power calculation error did not depend on axial length, age at surgery or target refraction. Mean myopic shift was 5.43 +/- 3.7 dioptres in the first 12 months following surgery, but was significantly greater when surgery was performed at less than 10 weeks of age.

Conclusion: This study demonstrates that IOL power can be calculated with reasonable accuracy in infants using current formulae. Factors such as age at the time of surgery, axial length, whether surgery is unilateral or bilateral, and the presence of systemic pathologies do not appear to influence the accuracy of lens power calculation or myopic shift by 36 months of age.