Refractive outcomes and prediction error following secondary intraocular lens implantation in children: a decade-long analysis

AIM: To evaluate the refractive outcomes, prediction error (PE) and factors affecting PE in children with aphakia following congenital cataract surgery undergoing secondary intraocular lens (IOL) implantation. METHODS: We analysed the records of children less than 16 years old who underwent secondary IOL implantation for aphakia following congenital cataract surgery. PE and absolute PE for each case calculated 3 months following secondary IOL implantation were analysed. Multiple regression analysis was performed to determine the relationship between age at secondary IOL implantation, axial length, keratometry readings and PE. RESULTS: 174 eyes of 104 children were analysed. Mean age at surgery was 6.08±3.75 years. The mean PE was 1.65±2.46 dioptres (D) (range -3.25 to 7.5 D) and mean absolute PE was 2.15±1.68 D (range 0-7.5 D) at 3 months. There was a statistically significant difference in absolute PE between eyes in which IOL calculation was performed using IOL master (1.80±1.40 D) versus IOL calculation under general anaesthesia with contact method (2.43±1.83 D), p=0.01. Multiple regression analysis revealed an inverse relationship between age at secondary IOL implantation and mean absolute PE (p=0.01). CONCLUSIONS: IOL power calculation with SRK II formula with sulcus placement of IOL gives favourable refractive outcomes. Though age-based refraction is targeted, a significant PE may be expected.