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Reanalysis of refractive growth in pediatric pseudophakia and aphakia
Susan Whitmer1, Aurora Xu, Scott McClatchey
1Ophthalmology Department, Naval Medical Center San Diego, San Diego, California, USA. susan.whitmer@med.navy.mil
Insights
A new refractive growth model (RRG3) accounts for spectacle lens effects in infants. RRG3 values were consistent across different surgical ages, proving its applicability in young children.
Area of Science:
- Ophthalmology
- Pediatric Ophthalmology
- Refractive Error Development
Background:
- The current refractive growth in children (RRG2) model is inaccurate for infants due to spectacle lens vertex distance effects.
- A new refractive growth model (RRG3) was developed to eliminate these optical effects.
Purpose of the Study:
- To develop and validate a new refractive growth model (RRG3) applicable to infants.
- To assess the applicability of RRG3 in pseudophakic and aphakic eyes, particularly in children undergoing early cataract surgery.
Main Methods:
- Calculated RRG3 values for pseudophakic and aphakic eyes from previous RRG2 analyses.
- Included eyes with surgery ≤10 years, follow-up ≥3.6 years.
- Compared RRG3 values in children operated on before vs. after 6 months of age.
Main Results:
- 78 pseudophakic and 70 aphakic eyes met inclusion criteria.
- Mean RRG3 values showed no significant difference between early (<6 months) and later (≥6 months) surgical age groups for both pseudophakic (P=0.053) and aphakic (P=0.59) eyes.
- Ages at surgery ranged from 0.25 to 9 years with a 9.5-year mean follow-up.
Conclusions:
- The new refractive growth model (RRG3) is theoretically applicable to infants, even those undergoing surgery before 6 months of age.
- RRG3 provides a more accurate assessment of refractive growth in young children by correcting for optical effects of spectacle lenses.
Background:
The current model of refractive growth in children (RRG2) is calculated as the slope of aphakic refraction at the spectacle plane versus the logarithm of adjusted age. However, this model fails in infants because of the optical effect of vertex distance of a spectacle lens on the effective power at the cornea. In this study, we developed a new model of refractive growth (RRG3) that eliminates the optical effect of vertex distance on the RRG2 model.
Methods:
We calculated RRG3 values for pseudophakic and aphakic eyes previously analyzed for RRG2. Inclusion criteria were age ≤10 years at the time of cataract surgery and follow-up time between measured refractions of at least 3.6 years and at least the age at first refraction plus 0.6 years. For both pseudophakic and aphakic eyes, we compared RRG3 values in children who had cataract surgery before age 6 months with those in children aged 6 months or older.
Results:
A total of 78 pseudophakic and 70 aphakic eyes met the inclusion criteria. Ages at surgery ranged from 0.25 to 9 years, with a 9.5-year mean follow-up time. The mean RRG3 value was not significantly different between the surgical age groups for both pseudophakic eyes (P = 0.053) and aphakic eyes (P = 0.59).
Conclusions:
The RRG3 values were not significantly different between the surgical age groups for both pseudophakic and aphakic eyes. Consequently, RRG3 is theoretically applicable even in the small eyes of infants having surgery before 6 months of age.
