Refractive changes following IOL implantation in pediatric patients

Purpose. To determine the refractive changes that occur in children undergoing cataract extraction with IOL implantation. Methods. 32 children (median 4.6 yrs., range 9 mos. to 17.7 yrs.) with a mean follow-up of 21.3 ± 14.1 (range 6-55) mos. were retrospectively reviewed. The magnitude, direction, and rapidity of post-op refractive changes, and the time to reach a stable post-op refraction were assessed. The predicted and final stable refraction, and the first and last post-op refraction were compared for each patient. Results. In the immediate post-op period there were large and rapid changes in the refraction, which stabilized within the first 3 mos. of follow up. In particular, the cylinder diminished in the early post-op period. The mean refractive change between the first and last post-op refraction for children less than 3 yrs. (n=11) was -1.03 ±1.83 (range -3.88 to 2.00) diopters, while for children between 3 and 6 yrs. (n=7) the change was -2.41 ±2.31 (range -5.5 to -0.12) diopters. For children older than 6 (n=14), the change was 0.27±2.18 (range -4.52 to 3.12) diopters. Conclusions. The immediate post-op refraction after IOL implantation is variable, but quickly stabilizes. The post-op cylinder usually resolves without interventions such as suture lysis. The current method of IOL calculation accurately predicts the post-op refraction in children. There is, however, a myopic shift post-operatively which is more marked in younger children than in those older than 6 yrs.

Duke Scholars

Author Edward George Buckley Ophthalmology

Author Laura Barlow Enyedi Ophthalmology