The optics of aphakic and pseudophakic eyes in childhood

The growth of the eye results in a myopic shift in aphakic and pseudophakic eyes during childhood. Cataract surgery after the age of 6 months, with or without lens implantation, appears to have little effect on the rate of refractive growth. Most children with pseudophakia have a large amount of myopic shift. This myopic shift is greatest in children with surgery at younger ages. It is also greater in eyes with high-power intraocular lenses due to an optical phenomenon analogous to the effect of vertex distance. The amount of myopic shift and the variance in rate of refractive growth can be predicted using an empiric, logarithmic model. We describe a revision of this logarithmic model to extend it patients with surgery before 3 months of age. We also analyze the variance in the rate of refractive growth, based on data from pseudophakic children with the longest follow-up in proportion to age.