Optical correction of aphakia following unilateral infantile cataract removal

To compare primary intra-ocular lens (IOL) implantation with use of press-on spherical lens for aphakia correction following unilateral infantile cataract removal.

Sixty infants with a unilateral cataract underwent cataract surgery and were randomly assigned to the IOL (A group) or no IOL group (B group). Residual refractive error was corrected with spectacles in the A group and a press-on spherical lens was used to treat aphakia in the B group. Grating visual acuity (VA) was measured and patients were followed for up to 1 year.

LogMAR VA in the operated eyes of both groups was significantly better 1 year than 1 month after surgery. Mean logMAR VA difference between 1 year and 1 month after surgery was higher in the A group (0.457 ± 0.110) than in the B group (0.323 ± 0.114, p < 0.0001). Serious inflammation occurred significantly more often in the A group than in the B group (p = 0.007). Visual axis opacity occurred more often in the A group than in the B group (pupillary membrane: A: six eyes, 20%, B: none, p = 0.024; lens reproliferation: A: 10 eyes, 33%, B: two eyes, 7%, p = 0.021). Glaucoma occurred equally in both groups (p = 0.612). No other complications occurred.

Primary IOL implantation appears to be a relatively safe, effective optical correction strategy following unilateral cataract extraction in this age group. Patients for whom an IOL is not suitable can be treated with a press-on spherical lens for optical correction.