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Surgical and visual results of pediatric epikeratophakia
Insights
Epikeratophakia successfully corrected aphakia in children with congenital or traumatic cataracts. This procedure offers a permanent solution, improving visual outcomes and aiding occlusion therapy.
Area of Science:
- Ophthalmology
- Pediatric Surgery
Background:
- Congenital and traumatic cataracts lead to aphakia in children.
- Aphakia correction in young children presents challenges, including contact lens management.
Purpose of the Study:
- To evaluate the efficacy of epikeratophakia for correcting aphakia in pediatric patients.
- To assess visual outcomes and refractive results following epikeratophakia.
Main Methods:
- Epikeratophakia was performed on 31 children (ages 2 months to 7 years) with unilateral aphakia.
- Follow-up included visual acuity measurements, refractive assessment, and corneal curvature analysis.
Main Results:
- 77% graft success rate in 27 patients with >4 months follow-up.
- Significant increase in corneal curvature (12.39 D) and average overrefraction of +2.14 D spherical equivalent.
- Improved visual acuities were observed, with some achieving 6/15 or better, particularly in younger patients.
Conclusions:
- Epikeratophakia is an effective surgical option for pediatric aphakia correction.
- The procedure offers a permanent correction and simplifies management compared to contact lenses, facilitating occlusion therapy.
Abstract:
We performed epikeratophakia for the correction of aphakia in 31 children, ages 2 months to 7 years, who had unilateral congenital or traumatic cataracts. In 27 patients with more than 4 months of follow-up, 23 of 30 (77%) grafts were successful. In the 15 patients with 6 months or more followup, the average increase in corneal curvature was 12.39 diopters. The average overrefraction needed to achieve emmetropia was + 2.14 diopters spherical equivalent. Two patients operated on within the first year of life have achieved 6/15 (20/50) visual acuities, as measured by visual evoked potentials. One patient operated on in the second year of life achieved 5/30 visual acuity, as measured by Allen cards. Two patients operated on for traumatic cataracts at ages 2 and 4 years achieved 6/9 (20/30) and 8/30 (Allen cards) visual acuities, respectively. Five older patients who had congenital cataracts or persistent hyperplastic vitreous showed some improvement in visual function. Advantages of epikeratophakia include the placement of most of the correction directly on the eye in a permanent attachment and the elimination of contact lens manipulation in uncooperative patients, so that more time and energy can be devoted to the occlusion therapy.