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The association between myopic shift and visual acuity outcome in pediatric aphakia
David R Weakley1, Eileen Birch, Scott K McClatchey
1Department of Ophthalmology, The University of Texas Southwestern Medical Center of Dallas, Dallas, TX, USA.
Summary
Pediatric aphakia after cataract surgery shows a link between the rate of refractive growth and visual outcomes. Faster refractive growth in aphakic eyes is associated with poorer visual acuity.
Area of Science:
- Ophthalmology
- Pediatric Ophthalmology
- Refractive Development
Background:
- Intraocular lens implantation following pediatric cataract surgery requires understanding refractive development.
- Significant variation in refractive change in aphakic and pseudophakic eyes is known, but causes are unclear.
Purpose of the Study:
- To investigate the correlation between the rate of refractive growth (RRG) and visual acuity outcomes in pediatric aphakia.
Main Methods:
- A multicenter, retrospective observational case series analyzed 125 eyes of 85 patients with cataract surgery before age 1 and at least 3 years of follow-up.
- Rate of refractive growth (RRG) was calculated using the logarithmic model of ocular growth.
- RRG was compared with final logMAR acuity using linear regression.
Main Results:
- A statistically significant correlation was found between RRG and final logMAR acuity (r(2) = 0.10; P <.01).
- The correlation was stronger in unilaterally aphakic eyes (r(2) = 0.19; P <.01) than bilaterally aphakic eyes (r(2) = 0.08; P <.01).
- Eyes with visual acuity of 20/60 or better exhibited a significantly lower RRG (4.1 D) compared to those with poorer acuity (5.4 D).
Conclusions:
- The rate of refractive growth in pediatric aphakia is correlated with visual acuity outcomes.
- Eyes with poorer visual acuity demonstrate a greater rate of refractive growth.