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Keratometric and refractive results of pediatric epikeratophakia
Insights
Pediatric epikeratophakia outcomes vary by age. Younger children, especially infants, experienced significant undercorrection and less predictable refractive results, suggesting it
Area of Science:
- Ophthalmology
- Pediatric Ophthalmology
- Refractive Surgery
Background:
- Epikeratophakia is a refractive surgical procedure.
- Congenital cataracts often require refractive correction in neonates.
- Accurate refractive outcomes are crucial for pediatric visual development.
Purpose of the Study:
- To evaluate the keratometric and refractive outcomes of pediatric epikeratophakia.
- To compare results between younger (<1 year) and older (>1 year) pediatric patients.
- To assess the accuracy of the Sanders-Retzlaff-Kraff (SRK) formula in pediatric epikeratophakia.
Main Methods:
- Retrospective analysis of pediatric patients undergoing epikeratophakia.
- Keratometric and refractive data collected preoperatively and postoperatively (6 months).
- Comparison of outcomes based on age groups and application of the SRK formula.
Main Results:
- Patients under 1 year had steeper preoperative corneas and required more correction.
- Younger patients showed significant undercorrection, with only 3/14 achieving emmetropia within 3 D.
- Younger children achieved 46% of predicted corneal curvature change vs. 85% in older children.
Conclusions:
- Epikeratophakia outcomes are less predictable in infants (<1 year).
- The SRK formula may be inaccurate for estimating refractive correction in very young children.
- Epikeratophakia is recommended as a secondary procedure for neonates with congenital cataracts.
Abstract:
Keratometric and refractive results of pediatric epikeratophakia showed that patients under 1 year of age had steeper corneas preoperatively and required more correction, as estimated by the Sanders-Retzlaff-Kraff regression formula. The average spherical equivalent of refractive error six months postoperatively was +6.92 +/- 4.67 diopters in patients under 1 year, and -0.72 +/- 4.22 D in patients over 1 year. Three of 14 younger patients and 35 of 54 older patients were within 3 D of emmetropia. Since March 1982, significant undercorrection has occurred only in patients 6 months old or younger. Younger children achieved an average of 46% of the predicted change in corneal curvature, while older children achieved 85%. Also, the Sanders-Retzlaff-Kraff formula may be inaccurate in estimating powers for younger children. Therefore, we recommend at this time that epikeratophakia be used as a secondary procedure in neonates with congenital cataracts.