Combined cataract extraction and epikeratophakia in children

Nineteen children between the ages of 2 1/2 and 6 1/2 years who had cataracts not associated with trauma and who were judged to be poor candidates for contact lens wear underwent combined cataract extraction and epikeratophakia, followed by intensive amblyopia therapy. Follow-up ranged from 6 months to 7 years. In these monocularly aphakic children, three (16%) of the original 19 procedures failed and the tissue lenses were removed; two of these were repeated successfully. The success rate for the surgery was 86% (18/21) and 95% (18/19) for the patients. Postoperative visual acuity of 20/50 or better was achieved in six (33%) of the 18 patients with successful surgery. Another 11 (61%) achieved between 20/60 and 20/200. Postoperative astigmatism ranged between 0 and 4 diopters, with an average of 1.7 diopters. The results demonstrate that epikeratophakia can be successfully combined with cataract extraction in children with visually significant non-traumatic cataracts and that the majority of such children demonstrate an improvement in visual acuity.