Elsevier

Ophthalmology

Volume 107, Issue 7, July 2000, Pages 1261-1266
Ophthalmology

Bilateral intraocular lens implantation in the pediatric population

Presented in part at the annual meeting of the American Academy of Ophthalmology, Orlando, Florida, October 1999.
https://doi.org/10.1016/S0161-6420(00)00141-XGet rights and content

Abstract

Purpose

To evaluate bilateral intraocular lens (IOL) implantation in children.

Design

Retrospective, noncomparative case series

Participants

Thirty pediatric patients with bilateral IOL implants at one institution with more than 6 months of followup.

Methods

Retrospective chart review.

Main outcome measures

Complications, visual acuity, axial length, and refractive changes were recorded.

Results

Thirty patients (60 eyes) had an average followup of 31 months (range, 7–69 months). Average age at implantation was 73 months (range, 12 days–13 years). At last followup, 91% of eyes had vision better than or equal to 20/40. Patients in the youngest age group (<2 years) demonstrated the most rapid refractive and axial length changes, and there were progressively smaller changes in older age groups. Only four patients had acuity differences between eyes of more than one line.

Conclusions

Bilateral IOLs are safe and effective in pediatric aphakia.

Section snippets

Methods

Medical records of all children who underwent IOL implantation in both eyes by one surgeon (MEW) were reviewed retrospectively. Patients were selected from a database of 185 consecutive IOL implantations in children at the Storm Eye Institute. Details of the surgical technique, IOL type and power, postoperative complications, preoperative and postoperative visual acuity, and examination findings at each followup visit were noted. Repeat axial lengths over time were obtained whenever possible.

Results

Thirty patients (60 eyes) were identified with more than 6 months of followup who underwent IOL implantation in both eyes by one author (MEW) from 1991 through 1998. Of the 30 study patients, 23 (46 eyes) underwent implantation primarily at the time of cataract extraction, and 7 (14 eyes) underwent implantation secondarily (Table 1). Nine patients had congenital cataracts and 17 were developmental. One patient had cataracts associated with radiation therapy, one with steroid treatment, and two

Discussion

Because of the uncertainty of long-term outcome, bilateral IOL implantation in children is still controversial. As more bilateral implantations are performed and more long-term results are reported, surgeons are better able to evaluate this option for their patients.

In our series of patients, the visual results of bilateral implantation generally have been good. Other authors have also reported good visual outcomes in young patients with IOLs.22, 23, 24, 25, 26, 27 However, these authors report

References (37)

Cited by (49)

  • Refractive lens exchange

    2014, Survey of Ophthalmology
  • Long-term results of extraction of childhood cataracts and intraocular lens implantation

    2013, Taiwan Journal of Ophthalmology
    Citation Excerpt :

    Six of 21 patients (28.6%) with existing nystagmus preoperatively had irreversible nystagmus postoperatively (Table 1). Implantation of IOLs in children is becoming an accepted practice for many surgeons.7–10 Despite the demonstrated efficacy and safety of pediatric cataract surgery, some challenging questions remain, including the most appropriate age for surgery, primary versus secondary IOL implantation, the intended postoperative target refraction, and IOL calculations.

View all citing articles on Scopus

Supported in part by an unrestricted grant to the Storm Eye Institute from Research to Prevent Blindness, Inc., New York, New York.

1

The authors have no proprietary interest in any entity connected with this manuscript.

View full text