Purpose: To evaluate stereoacuity and the factors that can influence stereopsis in children with unilateral pseudophakia.
Methods: Charts of 38 patients who were diagnosed with unilateral cataract and underwent cataract extraction with primary IOL implantation were retrospectively reviewed. Data were collected on gender, age, race, age at presentation and the surgery, cataract types, the presence of strabismus before and after cataract extraction, refractive error and the presence of anisometropia, best corrected visual acuity of both eyes, and stereoacuity.
Results: Thirty-eight patients were divided into 2 groups. Group I had 21 patients whose stereopsis was better than 400 seconds of arc. Seventeen patients in group II had stereopsis poorer than 400 seconds of arc. The mean ages at presentation and surgery were 4.9 and 6.3 years in group I and 2.7 and 3.0 in group II, respectively.(p=0.046,0.007) Posterior lenticonus was the most common cataract type in both groups.(p=0.20) Strabismus was more frequently associated with group II. Those who had no strabismus before and after cataract surgery were 66.7% in group I and 47.1% in group II.(p=0.02). Fifty-two percent of patients in group I had a VA of 20/40 or better, but in group II, only one patient had a VA of 20/40 (p<0.001). With a visual acuity of 20/40 or better as the reference level, the odds of having good stereopsis significantly decreased if visual acuity in the eye with the cataract was less than 20/60 based on the multiple regression logistic analysis.(OR=0.03, p=0.0027).
Conclusion: Stereopsis was better in children with later manifesting cataracts, absence of strabismus and in cases with a good postoperative visual acuity. The postoperative visual acuity was the most important factor affecting the outcome of stereopsis in children with unilateral pseudophakia.