Modern intraocular lens implants in children with new age limitations

Seventy-three children received modern designs of posterior and flexible anterior chamber intraocular lenses. Twenty-eight (38%) had anterior chamber and 45 (62%) had posterior chamber lenses implanted. Postoperative implant complications occurred in 38 (54%) eyes; the most frequent was secondary membrane formation. Six eyes (22%) with anterior chamber lenses and 25 eyes (58%) with posterior chamber lenses required posterior capsulotomies. Seventy percent of the posterior chamber lens recipients less than six years of age developed secondary membranes. All of these eyes had a discission except one Nd:YAG laser patient. Forty-eight percent of the patients with posterior chamber lenses over six years of age required posterior capsulotomies: 55% had Nd:YAG laser capsulotomies and 45% had discissions. Based upon these observations, we now recommend primary implantation of flexible anterior chamber lenses in three- to six-year old children who have tissue-free visual axes and for all secondary implantations. Primary posterior chamber lenses are recommended for children six years of age and older and for younger children who will tolerate a Nd:YAG laser capsulotomy.