Stereopsis in children with unilateral pseudophakia

To evaluate stereoacuity and the factors that can influence stereopsis in children with unilateral pseudophakia.

Charts of 38 patients who were diagnosed as having unilateral cataract and underwent cataract extraction with primary intraocular lens implantation were retrospectively reviewed. Data were collected on gender, age, race, age at presentation and the surgery, cataract types, the presence of strabismus before and after cataract extraction, refractive error and the presence of anisometropia, best corrected visual acuity (VA) of both eyes and stereoacuity.

Thirty-eight patients were divided into two groups. Group I had 21 patients whose stereopsis was better than 400 s of arc. Seventeen patients in group II had stereopsis poorer than 400 s of arc. The mean ages at presentation and surgery were 4.9 and 6.3 years in group I and 2.7 and 3.0 in group II, respectively (p = 0.046,0.007). Posterior lenticonus was the most common cataract type in both groups (p = 0.20). Strabismus was more frequently associated with group II. Those who had no strabismus before and after cataract surgery were 66.7% in group I and 47.1% in group II (p = 0.02). Fifty-two per cent of patients in group I had a VA of 20/40 or better, but in group II, only one patient had a VA of 20/40 (p<0.001). With a VA of 20/40 or better as the reference level, the odds of having good stereopsis decreased significantly if VA in the eye with the cataract was less than 20/60 based on the multiple regression logistic analysis (OR 0.03, p = 0.0027).

Stereopsis was better in children with later manifesting cataracts, in the absence of strabismus and in cases with a good postoperative VA. The postoperative VA was the most important factor affecting the outcome of stereopsis in children with unilateral pseudophakia.