A comparison of the rate of refractive growth in pediatric aphakic and pseudophakic eyes

Ophthalmology. 2000 Jan;107(1):118-22. doi: 10.1016/s0161-6420(99)00033-0.


Objective: To compare the rate of refractive growth in pseudophakic children's eyes to that of aphakic eyes.

Design: Multicenter, retrospective observational case series.

Participants: 83 patients with pseudophakic eyes (100 eyes) and 74 patients with aphakic eyes (106 eyes), with an age of surgery between 3 months and 10 years and a minimum follow-up time of 3 years or more, depending on the age at surgery.

Methods: A logarithmic model was used to analyze the rate of refractive growth for each eye.

Main outcome measures: Age at surgery, intraocular lens power, intraocular lens A-constant, initial postoperative refraction, final refraction, and final age.

Results: Overall, pseudophakic eyes showed a lesser rate of refractive growth than aphakic eyes (-4.6 diopter vs. -5.7 diopter, P = 0.03). This trend was also present but less significant when the eyes were grouped into those less than 6 months of age at surgery (-3.3 diopter vs. -4.6 diopter, P = 0.09) and older patients (-5.0 diopter vs. -6.1 diopter, P = 0.07). However, the mean quantity of myopic shift was greater in pseudophakic eyes than in aphakic eyes (-5.26 diopter vs. -4.54 diopter), despite shorter follow-up times in the pseudophakic eyes. This is due to the optical effects of a constant intraocular lens power in a growing eye.

Conclusions: Pediatric pseudophakic eyes have a slightly lesser rate of refractive growth than aphakic eyes. The new rate values should be used for predicting future refractions in these eyes.

Publication types

  • Comparative Study
  • Multicenter Study

MeSH terms

  • Aphakia, Postcataract / complications*
  • Aphakia, Postcataract / physiopathology
  • Child
  • Child, Preschool
  • Eye / growth & development
  • Humans
  • Hyperopia / etiology*
  • Hyperopia / physiopathology
  • Infant
  • Lens Implantation, Intraocular*
  • Myopia / etiology*
  • Myopia / physiopathology
  • Pseudophakia / complications*
  • Pseudophakia / physiopathology
  • Refraction, Ocular
  • Retrospective Studies