Outcome and complications of intraocular lenses in children with cataract

To assess prospectively the complications and changes in refraction, axial length, and keratometry after intraocular lens (IOL) implantation in children with congenital, developmental, and traumatic cataracts.

The Children's Hospital, Dublin, Ireland.

The study comprised 24 eyes of 20 patients, aged 4 weeks to 12 years, who had extracapsular cataract extraction and posterior chamber IOL implantation. Mean follow-up was 103 weeks (range 34 to 270 weeks).

Six eyes with congenital cataracts operated on between 4 and 28 weeks of age had central, steady, maintained fixation postoperatively. In the developmental cataract group, 64% achieved a visual acuity of 6/24 or better and 43%, 6/12 or better. In the three traumatic cases, visual acuities were 6/6, 6/9, and 6/24. Posterior capsule opacification occurred in 95.8% of eyes and was treated with a neodymium: YAG or Zeigler knife posterior capsulotomy as a secondary procedure. Other postoperative complications (membranous uveitis, iris capture, posterior synechias, iris prolapse) occurred in 29.2% of eyes.

With careful management and patient selection, the use of IOLs in children can produce good visual results with a minimum of complications. Further follow-up is needed to assess the long-term visual outcome, complications, and changes in refraction.