[Unilateral congenital cataracts removed early: long-term refractive changes]

Area of Science:

• Ophthalmology
• Pediatric Ophthalmology
• Refractive Surgery

Context:

• Unilateral congenital cataracts require early intervention to prevent amblyopia.
• Intraocular lens (IOL) implantation is a common surgical approach.
• Accurate IOL power selection is vital for long-term visual function.

Purpose:

• To predict long-term refractive error progression after primary IOL implantation for unilateral congenital cataracts.
• To guide intraocular lens power selection for optimal functional vision.
• To understand refractive outcomes in pediatric cataract surgery.

Summary:

• This retrospective study evaluated 53 children with unilateral congenital cataracts who underwent primary IOL implantation.
• The mean follow-up was 6.8 years, with a mean age at surgery of 2.98 years.
• A mean myopic shift of -0.83 D/year was observed, with significantly greater shifts in children operated on before age 2 (-9.15 D) compared to older children (-2.13 D).
• Visual acuity averaged +0.25 logMAR, and four IOLs were revised due to significant anisometropia.

Impact:

• Early primary IOL implantation and amblyopia treatment yield good long-term visual results.
• Refractive changes in very young children are highly variable, impacting IOL choice.
• IOL exchange is a viable option for managing substantial anisometropia that hinders amblyopia rehabilitation.