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Primary intraocular lens implantation in infants: complications and visual results
Anna Lundvall1, Charlotta Zetterström
1St Erik's Eye Hospital, Karolinska Institute, Stockholm, Sweden. anna.lundvall@sankterik.se
Insights
Cataract surgery with intraocular lens (IOL) implantation in infants showed significant complications like visual axis opacification and glaucoma. However, after-cataract membrane formation was the primary issue, with a low incidence of glaucoma reported.
Area of Science:
- Ophthalmology
- Pediatric Surgery
- Medical Device Technology
Background:
- Congenital cataracts require timely intervention to prevent visual impairment.
- Intraocular lens (IOL) implantation in infants is a complex procedure with potential complications.
Purpose of the Study:
- To evaluate the complications and visual outcomes of cataract extraction with primary IOL implantation in infants within the first year of life.
Main Methods:
- Retrospective study of 28 children (31 eyes) undergoing cataract surgery with primary IOL implantation.
- Median age at surgery was 2.5 months, with a median follow-up of 36 months.
Main Results:
- 70% of eyes developed visual axis opacification requiring further surgery.
- Complications included vitreous hemorrhage, retinal detachment, IOL luxation (especially in persistent fetal vasculature cases), and glaucoma.
- Visual acuity varied significantly, with many eyes achieving counting fingers or worse, particularly those with persistent fetal vasculature.
Conclusions:
- After-cataract membrane formation was the most frequent complication.
- The incidence of chronic glaucoma was low at the final follow-up.
Purpose:
To evaluate the complications and visual results in a consecutive series of patients having cataract extraction with intraocular lens (IOL) implantation in the first year of life.
Setting:
St. Erik's Eye Hospital, Stockholm, Sweden.
Methods:
This retrospective study comprised 28 children (31 eyes) who had cataract surgery with primary IOL implantation.
Results:
The median age at surgery was 2.5 months (range 8 days to 10 months). The median follow-up was 36 months. Two newborns with persistent fetal vasculature (PFV) who had surgery at 8 days and 17 days, respectively, developed intraoperative vitreous hemorrhage; a retinal detachment developed in 1 of the eyes. Intraocular lens luxation occurred in 2 infants with PFV. Seventy percent of eyes developed opacification of the visual axis that required additional surgery. Chronic glaucoma developed in 2 eyes and transitory glaucoma in 1 eye. Two of the glaucoma cases occurred in eyes with PFV. In 7 eyes of 4 infants with bilateral cataract, the median visual acuity was 20/63 (range 20/25 to 20/100). In 12 infants with unilateral cataract without PFV, 7 achieved a visual acuity between 20/32 and 20/200 (median 20/63), 4 achieved counting fingers (CF), and 1 achieved light perception. In 12 eyes with PFV, 2 achieved a visual acuity of 20/200 and the rest achieved CF or worse.
Conclusions:
After-cataract with membrane formation was the main complication in infants with primary IOL implantation. The glaucoma incidence was low at the last follow-up.
