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Refractive outcomes and prediction error following secondary intraocular lens implantation in children: a decade-long
Bhamy Hariprasad Shenoy1, Vaibhev Mittal, Amit Gupta
1Pediatric Ophthalmology and Strabismus Services, Jasti V Ramanamma Children's Eye Care Center, Kallam Anji Reddy Campus, LV Prasad Eye Institute, , Hyderabad, Andhra Pradesh, India.
Insights
Secondary intraocular lens (IOL) implantation in children with aphakia after congenital cataract surgery showed favorable refractive outcomes. Age at implantation inversely affected prediction error, with IOL Master calculations yielding better accuracy than those under general anesthesia.
Area of Science:
- Ophthalmology
- Pediatric Ophthalmology
- Refractive Surgery
Background:
- Congenital cataracts are a leading cause of childhood blindness.
- Secondary intraocular lens (IOL) implantation is a common procedure to correct aphakia after congenital cataract surgery.
- Accurate refractive outcomes are crucial for visual development in children.
Purpose of the Study:
- To evaluate refractive outcomes after secondary IOL implantation in children with aphakia.
- To assess prediction error (PE) and identify factors influencing PE.
- To analyze the impact of age and measurement methods on refractive accuracy.
Main Methods:
- Retrospective analysis of 174 eyes from 104 children (<16 years) undergoing secondary IOL implantation.
- Calculation of PE and absolute PE at 3 months post-implantation.
- Multiple regression analysis to correlate age, axial length, keratometry, and PE.
Main Results:
- Mean PE was 1.65±2.46 D and mean absolute PE was 2.15±1.68 D.
- IOL Master measurements showed significantly lower absolute PE (1.80±1.40 D) compared to general anesthesia with contact method (2.43±1.83 D).
- Older age at secondary IOL implantation was associated with lower absolute PE (p=0.01).
Conclusions:
- Secondary IOL implantation with the SRK II formula and sulcus placement yields favorable refractive outcomes.
- While age-based refraction is targeted, significant prediction error is possible.
- IOL Master measurement is preferred for improved accuracy in pediatric aphakia correction.
Aim:
To evaluate the refractive outcomes, prediction error (PE) and factors affecting PE in children with aphakia following congenital cataract surgery undergoing secondary intraocular lens (IOL) implantation.
Methods:
We analysed the records of children less than 16 years old who underwent secondary IOL implantation for aphakia following congenital cataract surgery. PE and absolute PE for each case calculated 3 months following secondary IOL implantation were analysed. Multiple regression analysis was performed to determine the relationship between age at secondary IOL implantation, axial length, keratometry readings and PE.
Results:
174 eyes of 104 children were analysed. Mean age at surgery was 6.08±3.75 years. The mean PE was 1.65±2.46 dioptres (D) (range -3.25 to 7.5 D) and mean absolute PE was 2.15±1.68 D (range 0-7.5 D) at 3 months. There was a statistically significant difference in absolute PE between eyes in which IOL calculation was performed using IOL master (1.80±1.40 D) versus IOL calculation under general anaesthesia with contact method (2.43±1.83 D), p=0.01. Multiple regression analysis revealed an inverse relationship between age at secondary IOL implantation and mean absolute PE (p=0.01).
Conclusions:
IOL power calculation with SRK II formula with sulcus placement of IOL gives favourable refractive outcomes. Though age-based refraction is targeted, a significant PE may be expected.
