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Published on: March 29, 2022
Minimal myopic shift in pseudophakic versus aphakic pediatric cataract patients
Rosanne Superstein1, Steven M Archer, Monte A Del Monte
1McGill University, Montreal, Quebec, Canada.
Insights
Children with pseudophakia (artificial lenses) experience less myopic shift after surgery than those with aphakia (no lens). This suggests aiming for emmetropia is effective for pseudophakic pediatric eyes.
Area of Science:
- Ophthalmology
- Pediatric Ophthalmology
- Refractive Surgery
Background:
- Pediatric aphakia and pseudophakia can lead to significant refractive changes.
- Understanding postoperative refractive development is crucial for visual outcomes.
Purpose of the Study:
- To compare postoperative refractive changes in pediatric aphakic and pseudophakic eyes.
- To evaluate the refractive outcomes of intraocular lens (IOL) implantation in children.
Main Methods:
- Retrospective review of medical records for pediatric patients.
- Calculation of mean refractive error change over time for aphakic and pseudophakic groups.
- Analysis of aggregate postoperative refractive change curves.
Main Results:
- Studied 233 aphakic and 92 pseudophakic eyes.
- Pseudophakic eyes showed a mean myopic shift of 1.5 D, while aphakic eyes showed 7.8 D.
- Aphakic eyes exhibited significantly greater myopic shift compared to pseudophakic eyes.
Conclusions:
- Pseudophakic eyes demonstrate less postoperative myopic shift than aphakic eyes.
- Targeting emmetropia with IOL power selection appears beneficial for pseudophakic children.
- Further data is needed for pseudophakic children under two years old.
Purpose:
To evaluate postoperative refractive changes in aphakic and pseudophakic children in a comparative case series.
Methods:
The medical records of pediatric patients with aphakia and pseudophakia were reviewed retrospectively. The mean change in refractive error from one postoperative examination to the next was calculated at each age to give aggregate curves of postoperative refractive change for each group.
Results:
A total of 233 aphakic and 92 pseudophakic eyes were studied. The median age at the time of surgery was 0.8 years (range, 0.0-16 years) for patients with aphakia and 7.3 years (range, 1.5-19.9 years) for patients with pseudophakia (P <.0001). The postoperative refraction curves at comparable ages of 2 to 20 years showed a total mean myopic shift of 1.5 D for patients with pseudophakia and 7.8 D for patients with aphakia. An age-matched subset of patients with aphakia also showed more myopic shift than those with pseudophakia.
Conclusions:
Pseudophakic eyes show less postoperative myopic shift than aphakic eyes. Selecting intraocular lens powers aimed at producing initial emmetropic refractions has been a good strategy in our cohort of patients with pseudophakia. However, our data are insufficient for conclusions regarding children with pseudophakia younger than 2 years, in whom larger myopic shifts may occur.
