Pediatric intraocular lens implantation. Surgical results and complications in more than 300 patients

Ophthalmology. 1998 Jan;105(1):112-8; discussion 118-9. doi: 10.1016/s0161-6420(98)91568-8.


Objective: The study aimed to review pediatric intraocular lens (IOL) implantations performed in the authors' institution for the past 7 years.

Study design: The study design was a retrospective chart review.

Participants: All children who underwent IOL placement between January 1, 1989, and January 31, 1996, at ages 2 to 16 years were studied. Follow-up was a minimum of 6 months up to 4 years with an average of 13 months.

Intervention: Placement of a primary or secondary posterior chamber IOL was performed.

Main outcome measures: Visual acuity and possible complications were tabulated.

Results: Fifty-seven percent of the cataracts were caused by trauma, and 37% were infantile cataracts. Visual acuities of 20/40 or better were attained in 44% of eyes and visual acuities of 20/50 to 20/80 were attained in 27% of eyes. Visual acuities were better in children older than 4 years of age (P = 0.001). Compliance with amblyopia therapy improved vision (P = 0.004). Fibrinous membranes occurred in 41 eyes (13%), and posterior capsule opacification occurred in 120 eyes (39%). There were no significant differences in visual outcome and complications between primary and secondary implants (17%) or between capsular bag and sulcus fixation (27%). The first stable postoperative refraction was predicted accurately in most patients, based on the Sanders-Retzlaff-Kraff II (SRK II) formula and intraoperative corneal curvature and axial length determinations. The mean refraction differed from the goal by only +0.28 diopter and 84% were within +/- 2 diopters. A few patients showed large overcorrections or undercorrections. On average, no myopic shift occurred.

Conclusions: Short-term results of IOLs implanted in children older than 2 years of age were favorable. Visual acuities obtained were better than 20/80 in 71% despite a high prevalence (28%) of penetrating trauma. Major complications were rare.

MeSH terms

  • Adolescent
  • Cataract / congenital
  • Cataract / etiology
  • Cataract Extraction*
  • Child
  • Child, Preschool
  • Eye Injuries, Penetrating / complications
  • Eye Injuries, Penetrating / surgery
  • Female
  • Follow-Up Studies
  • Humans
  • Lens Implantation, Intraocular*
  • Lens, Crystalline / injuries
  • Male
  • Postoperative Complications*
  • Refraction, Ocular
  • Retrospective Studies
  • Treatment Outcome
  • Visual Acuity / physiology*