Single-piece AcrySof intraocular lens implantation in children with congenital and developmental cataract

To evaluate surgical outcomes of 1-piece AcrySof SA30AL intraocular lens (IOL) (Alcon Laboratories) implantation in children having surgery for congenital and developmental cataracts.

Iladevi Cataract & IOL Research Centre, Raghudeep Eye Clinic, Ahmedabad, India.

This prospective observational study comprised 134 consecutive eyes of 84 children from 2 to 15 years old who had surgery for congenital and developmental cataract. Two groups were formed depending on the age of the child at surgery. Primary posterior continuous curvilinear capsulorhexis (PCCC) was performed in children younger than 6 years (Group 1, 66 eyes), and no PCCC was performed in children older than 6 years (Group 2, 68 eyes). Vitrectomy was not performed. An AcrySof IOL was implanted in the bag in all eyes except 1 in Group 1, which received a sulcus-fixated IOL. The study's primary outcome measures were the incidence of visual axis obscuration and the need for a secondary procedure to clear the axis. Secondary observations included the incidence of posterior synechias, cell deposits, and haptic compression. A test of proportion was applied to determine whether age was a risk factor for the development of visual axis obscuration.

The mean age at surgery was 6.0 years +/- 3.2 (SD). The mean follow-up was 2.6 +/- 0.6 years. In Group 1, 20 eyes (30.3%) developed visual axis obscuration but only 6 (9.1%) required a secondary procedure. In Group 2, 20 eyes (29.4%) developed visual axis obscuration and 10 (14.7%) required secondary procedures. Posterior synechias were observed in 2 eyes (3.0%) in Group 1 and none in Group 2. Cell deposits were seen in 8 eyes (12.1%) in Group 1 and 8 eyes (11.8%) in Group 2. Haptic compression was noted in 1 eye in Group 2. Mild IOL decentration was observed in the 1 eye with a sulcus-fixated IOL.

The 1-piece AcrySof IOL provided satisfactory visual axis clarity, produced an acceptable inflammatory response, and maintained centration in pediatric eyes.