Outcome of cataract surgery with primary intraocular lens implantation in children

AIM: To report the results of paediatric cataract surgery with primary intraocular lens (IOL) implantation. METHODS: Children with congenital or developmental cataract who underwent phacoaspiration with posterior chamber (PC) IOL implantation were retrospectively studied. Group A included children with polymethyl methacrylate, group B hydrophobic acrylic and group C silicone IOLs. Outcome measures were visual axis clarity, visual outcome and refractive changes. RESULTS: There were 230 children (381 eyes) with the age ranging from 1 months to 15 years. Group A comprised 208, group B 144 and group C 29 eyes. Posterior capsule opacification was seen in 38/208 in group A and 21/144 in group B and 4/29 eyes in group C. The mean refractive error at 2 weeks, 1 year and 3 years after cataract surgery in the age group ≤2 years was +3.38±3.07 D (median +3.75 D), +1.72 D±3.19 (median +1 D) and -0.51 D±3.59 (median -0.5 D); in the age group >2-8 years +0.84±3.18 D (median+1.5 D), +0.27 D±3.14 (median +0.5 D) and -0.62 D±2.81(median -0.75D); and in the age group >8 years -0.44±1.73 D (median -0.5 D), -0.70±1.77 D (median -0.75 D) and -0.89 D±1.60 (median -0.75D) respectively. Children ≤2 years had a significant myopic shift (p<0.001). LogMAR visual acuity was ≥0.3 in 62.2% of eyes in bilateral and 30.90% in the unilateral group. CONCLUSIONS: Paediatric cataract surgery with primary PCIOL implantation is safe. Refractive changes and PCO are the main hurdles for achieving optimal visual outcome.