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[Intraocular lens implantation in the first year of life]
P De Laage De Meux1, R Zafad, C Arndt
1Service d'ophtalmologie et d'ophtalmopédiatrie, Fondation Ophtalmologique A de Rothschild, 29, rue Manin, 75019, Paris.
Insights
This study on congenital cataracts found that undercorrected intraocular lens implantation in infants led to emmetropia by age five. Most infants experienced significant visual improvement with minimal complications.
Area of Science:
- Ophthalmology
- Pediatric Surgery
Context:
- Congenital cataracts require early intervention to prevent visual impairment.
- Intraocular lens (IOL) implantation is a common surgical approach for pediatric cataracts.
Purpose:
- To evaluate the refractive outcomes and complications of primary posterior chamber intraocular lens implantation in infants with congenital cataracts.
- To assess the effectiveness of age-based undercorrection strategies for achieving emmetropia by age five.
Summary:
- Thirty-six eyes of 23 infants (1-11 months) underwent IOL implantation with capsulorhexis and anterior vitrectomy.
- Age-specific undercorrection (35% for <6 months, 25% for 7-11 months) aimed for emmetropia at age five.
- Average follow-up was 15.3 months; 34 eyes showed subjective visual improvement.
Impact:
- Postoperative refraction approached emmetropia by two years (average +0.19 D).
- Complications included posterior synechiae (9 eyes) and posterior opacification (8 eyes).
- This approach demonstrates successful visual rehabilitation in infants with congenital cataracts.
Abstract:
We evaluated 36 eyes in 23 infants between one and eleven months old who had primary posterior chamber intraocular lens implantation for congenital cataracts. All eyes had a capsulorhexis of anterior and posterior capsulae and anterior vitrectomy. In order to obtain an emmetropia at age 5 years, we chose a 35% undercorrection of lens power for infants less than six months old, and 25% for infants between seven and eleven months old. The average follow-up was 15.3 months. Nine eyes developed posterior synechiae and eight developed a posterior opacification. The average postoperative refraction was +5.81 dioptries at one month, +4.56 at four months, +1.5, at one year, and +0.19 at two years. There was a marked subjective visual improvement in 34 eyes.