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Changes in the aphakic refraction of children with unilateral congenital cataracts
1Department of Ophthalmology, Children's Hospital, Boston, Mass 02115.
Insights
Infants with unilateral congenital cataracts experience the fastest refractive error changes in their aphakic eyes during infancy. This trend slows in early childhood, aiding in future contact lens power adjustments.
Area of Science:
- Ophthalmology
- Pediatric Medicine
- Refractive Error Research
Background:
- Unilateral congenital cataracts require early surgical intervention.
- Aphakic eyes in infants present unique refractive challenges.
- Longitudinal refractive data is crucial for managing pediatric aphakia.
Purpose of the Study:
- To analyze refractive error changes in the aphakic eye of infants post-cataract surgery.
- To establish a refractive trend for the first four years of life.
- To inform contact lens prescription adjustments for pediatric aphakia.
Main Methods:
- Serial refractions were performed on 42 infants with unilateral congenital cataracts.
- Data collection spanned the first four years of life post-surgery (by 6 months).
- Intensive follow-up on 14 patients (185 refractions) provided detailed refractive data.
Main Results:
- Mean spherical equivalent decreased from +30.75 D to +20.86 D by 48 months.
- The most rapid decrease occurred within the first year of life.
- The rate of refractive change per month decreased progressively over time.
Conclusions:
- Refractive error in the aphakic eye decreases most rapidly in infancy.
- The rate of change slows significantly in subsequent childhood years.
- This data aids in predicting refractive needs and optimizing management for congenital cataract patients.
Abstract:
Forty-two infants who presented to the Children's Hospital in Boston with unilateral congenital cataracts and had cataract surgery by 6 months of age received serial refractions (N = 369) of their aphakic eyes during the first 4 years of life. The 14 patients followed most intensively (185 refractions) showed a rapid decrease in mean spherical equivalent during the first year of life from +30.75 D to +26.36 D, with a less rapid decrease thereafter (24 months, +23.02 D; 36 months, +21.19 D; 48 months, +20.86 D). The rate of change per month decreased from .43 D between 1 and 6 months, .37 D between 6 and 12 months, .30 D between 12 and 18 months, .24 D between 18 and 24 months, and less than .19 D per month thereafter. This study shows that the refractive error of the aphakic eye of patients treated for unilateral congenital cataracts decreases most rapidly during infancy and less rapidly during the next few years of childhood. This information will be helpful in facilitating the treatment of these infants by allowing an approximation of their future contact lens refractive power changes.