Long-term Outcomes of Undercorrection Versus Full Correction After Unilateral Intraocular Lens Implantation in Children

Am J Ophthalmol. 2012 Apr;153(4):602-8, 608.e1. doi: 10.1016/j.ajo.2011.08.046. Epub 2011 Dec 28.

Abstract

Purpose: To evaluate the impact of full correction vs undercorrection 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 2 groups based on their 1-month-postoperative refraction: Group 1 (full correction) -1.0 to +1.0 diopter (D) and Group 2 (undercorrection) ≥+2.0 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=.45) and mean follow-up (Group 1, 5.8±3.7 years; Group 2, 6.1±3.5 years; P=.69) were similar for the 2 groups. The change in refractive error (Group 1, -0.4±0.5 D/y; Group 2, -0.3±0.2 D/y; P=.70) and last median logMAR acuity (Group 1, 0.4; Group 2, 0.4; P=.54) were not significantly different between the 2 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.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Case-Control Studies
  • Cataract Extraction
  • Child
  • Child, Preschool
  • Follow-Up Studies
  • Humans
  • Lens Implantation, Intraocular*
  • Myopia / physiopathology*
  • Postoperative Period
  • Pseudophakia / physiopathology*
  • Refraction, Ocular / physiology
  • Retrospective Studies
  • Visual Acuity / physiology*