Long-term Outcomes of Under Correction versus Full Correction after Unilateral Intraocular Lens Implantation in Children

• Authors: Scott R Lambert, Emory University; Steven M. Archer, University of Michigan; M. Edward Wilson, Medical University of South Carolina; Rupal H. Trivedi, Medical University of South Carolina; Monte A Del Monte, University of Michigan; Michael Lynn, Emory University
• Journal Title: American Journal of Ophthalmology
• Volume: Volume 153, Number 4
• Publisher: Elsevier: 12 months | 2012-04, Pages 602-608.e1
• Type of Work: Article | Post-print: After Peer Review
• Publisher DOI: http://doi.org/10.1016/j.ajo.2011.08.046
• Subjects: Health Sciences, Opthamology

Abstract

Purpose To evaluate the impact of full correction versus under correction on the magnitude of the myopic shift and postoperative visual acuity after unilateral intraocular lens (IOL) implantation in children. Design Retrospective case control study Methods The medical records of 24 children who underwent unilateral cataract surgery and IOL implantation at 2 to <6 years of age were reviewed. The patients were divided into two groups based on their 1 month postoperative refraction: Group 1 (full correction) −1.00 to +1.00 D; and Group 2 (under correction) ≥+2.00 D. The main outcome measures included the change in refractive error per year and visual acuity for the pseudophakic eyes at last follow-up visit. The groups were compared using the independent groups t-test and Wilcoxon rank-sum test. Results The mean age at surgery (Group 1, 4.2 ± 0.9 years, n=12; Group 2, 4.5 ± 1.0 years, n=12; p=0.45) and mean follow-up (Group 1, 5.8 ± 3.7 years; Group 2, 6.1 ± 3.5 years; p=0.69) were similar for the two groups. The change in refractive error (Group 1, −0.4 ± 0.5 D/yr; Group 2, −0.3 ± 0.2 D/yr; p=0.70) and last median logMAR acuity (Group 1, 0.4; Group 2, 0.4; p=0.54) were not significantly different between the two groups. Conclusions We did not find a significant difference in the myopic shift or the postoperative visual acuity in children aged 2 to <6 years of age following unilateral cataract surgery and IOL implantation if the initial postoperative refractive error was near emmetropia or undercorrected by 2 diopters or more.