Accuracy of Intraocular lens power calculation in pediatric traumatic cataract
Priya Goyal1, Shailja Tibrewal1, Suma Ganesh1
1Department of Pediatric Ophthalmology, Strabismus and Neuro-Ophthalmology, Dr Shroff's Charity Eye Hospital, New Delhi, India.
Insights
Prediction error in pediatric traumatic cataract surgery was evaluated. Shorter axial lengths were associated with higher prediction error, and fellow eye keratometry reduced simulated error in scarred corneas.
Area of Science:
- Ophthalmology
- Pediatric Surgery
- Refractive Error Analysis
Background:
- Traumatic cataracts in children present unique surgical challenges.
- Accurate refractive outcomes are crucial for visual development post-surgery.
- Intraocular lens (IOL) implantation aims to restore visual function but can be affected by prediction error (PE).
Purpose of the Study:
- To assess the prediction error (PE) in pediatric traumatic cataract surgery with primary or secondary intraocular lens (IOL) implantation.
- To identify factors influencing PE in this patient population.
Main Methods:
- Retrospective analysis of unilateral traumatic cataract cases in children (≤16 years).
- Absolute PE calculated by comparing target refraction with observed refraction post-surgery.
- Simulated PE assessed using fellow eye or standard keratometry (K) in cases with corneal scarring.
Main Results:
- Mean absolute PE was 1.63 ± 1.8D.
- Absolute PE was higher in shorter axial lengths (AXL) (P=0.039 in univariate analysis).
- Multivariate analysis showed no significant factors affecting absolute PE; higher PE variability observed in eyes with corneal scars.
Conclusions:
- Absolute PE in pediatric traumatic cataract surgery is influenced by axial length, being higher with shorter lengths.
- In cases of corneal scarring affecting the visual axis, using the fellow eye's keratometry resulted in lower simulated PE compared to standard keratometry.
Purpose:
To evaluate the prediction error (PE) in pediatric traumatic cataract surgery involving primary or secondary intraocular lens implantation (IOL) and the factors affecting it.
Methods:
Retrospective data of unilateral traumatic cataract eyes of children aged ≤16 years were collected between February 2019 and March 2022 at a tertiary eye care hospital. Absolute PE was calculated by deducting the target refraction from the observed refraction at 6 weeks postsurgery following suture removal. Simulated PE was calculated in eyes with corneal scar replacing the affected eye keratometry (K) with the K of the fellow eye and standard K (44D) and was then compared with absolute PE.
Results:
Fifty children with a mean age of 9.5 years (2-16 years) were included. Mean absolute PE was 1.63 ± 1.8D (0 to 9D). Absolute PE was not affected by the age at surgery, method of biometry, duration of injury, type of cataract surgery, position of IOL, and preoperative keratometry. The absolute PE was affected by axial length (AXL) being <1.5D in AXL of 22.73 ± 0.84 mm, <1.5-2D in AXL of 22.07 ± 0.61 mm, and >2D in AXL of 22.01 ± 0.74 mm ( P = 0.039) in univariate analysis. In multivariate analysis, none of the factors affected the absolute PE. In 34 eyes with corneal scar, higher variability in PE was observed. The standard K resulted in greater simulated PE as compared to the affected eye average K in eyes with scar involving the visual axis.
Conclusion:
Absolute PE following pediatric traumatic cataract was studied. It was higher in shorter AXLs. In corneal scar involving the visual axis, using the fellow eye K yielded lesser simulated PE as compared to standard K.
