PubMed | In.Sight, L V Prasad Eye Institute and V Prasad Eye Institute
Type: | Journal: American journal of ophthalmology | Year: 2016
Initial undercorrection of intra-ocular lens (IOL power) is a common practice in children undergoing pediatric cataract surgery. However, long term refractive status of these children is largely unknown. The purpose of this study is to analyze the long-term refractive status of these children.Retrospective observational study METHODS: We analyzed records of children (< 7 yrs) who underwent cataract surgery where a primary IOL implantation was performed and had completed follow-up upto atleast 7 years of age. Data was collected regarding demographics, etiology of cataract, method of undercorrection, serial follow-up refractions. Prediction error was defined as refractive error minus emmetropia. Main outcome measure was prediction error at age 7.84 eyes of 56 children (28unilateral and 28 bilateral cases) met the study criteria. Median age at surgery was 3.3 (Inter-quartile range, IQR: 2.7 -5) years and median follow up period was 3.75 years. At seven years, median absolute prediction was 1.5D (IQR: 0.75-2D). 7/84 (8.3%) children achieved emmetropia while an equal proportion were myopic (45%) or hypermetropic (46%). Prediction error adjusted for using both eyes at seven years was not significantly different in any group (p>0.05). Maximum myopic shift was observed in children < 2 years. Age at surgery was the only significant factor that influenced prediction error ( = -0.32; p=0.001).This study suggests that children undercorrected using guidelines suggested by Enyedi et al may achieve an acceptable refractive error at seven years of age. However, in children < 2 years of age, more hypermetropia may be observed. More studies are needed to validate various methods of undercorrection and compare with other guidelines.