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Long-term outcomes of intended undercorrection intraocular lens implantation in pediatric cataract

Authors Lekskul A, Chuephanich P, Charoenkijkajorn C

Received 1 June 2018

Accepted for publication 15 August 2018

Published 2 October 2018 Volume 2018:12 Pages 1905—1911


Checked for plagiarism Yes

Review by Single-blind

Peer reviewer comments 2

Editor who approved publication: Dr Scott Fraser

Apatsa Lekskul, Pichaya Chuephanich, Chao Charoenkijkajorn

Department of Ophthalmology, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand

Purpose: To evaluate the postoperative refraction of intended undercorrection after intraocular lens (IOL) implantation in pediatric cataract patients.
Design: A cross-sectional study (data collected by retrospective chart review).
Patients and methods: The medical records of children aged under 10 years, who underwent cataract surgery with IOL implantation at the Ramathibodi Hospital between January 2000 and May 2018, were reviewed. IOL power calculations were 30%, 25%, 20%, 15% and 10% undercorrected if children were aged 6–12, 13–24, 25–36, 37–48 and 49–60 months, respectively. Two diopters (D) undercorrection was used in children aged between 5 and 8 years and one diopter undercorrection was used in children aged between 8 and 10 years. The main outcome measure was the postoperative refractive errors at the last follow-up visit.
Results: In total, 50 children (21 females and 29 males, 16 unilateral and 34 bilateral, 84 eyes) met the inclusion criteria for this study. Mean age at the time of surgery was 77.82±31.24 months. Mean follow-up time was 56.56±45.83 months. The main outcome in this study was the postoperative refractive error in children aged 7 years or more. We found 74 eyes of 44 children who were aged 7 years or more at last follow-up visit. In total, 45 eyes were myopic (-0.25 to -8.25 D) with a mean refraction of -2.26±2.16 D. A further 21 eyes were hyperopic (+0.25 to +3.25 D), with a mean refraction of +1.05±0.79 D and eight eyes were emmetropic or having only astigmatism.
Conclusion: The major postoperative refractive error at the last follow-up time was myopia. We have to adjust the IOL calculation formula to specify more undercorrection, with the aim of achieving more optimal refractive outcomes in adulthood.

Keywords: pseudophakic, refraction, formula, myopia, emmetropization

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