Primary intraocular lens implantation for unilateral idiopathic cataract in children.

BACKGROUND: To examine the efficacy of intraocular lens implantation on visual rehabilitation and ocular growth in children with unilateral idiopathic cataracts. METHODS: Preoperative characteristics, visual outcome and postoperative refraction change were analyzed through a retrospective study of the charts of children who underwent cataract removal and primary intraocular lens implantation for unilateral idiopathic cataracts between 1994 and 2003. RESULTS: Thirty-one children were included in this study. Preoperatively, 83% of the eyes with cataracts had best corrected visual acuity (BCVA) of less than 20/200. Posterior subcapsular opacity was the most common type of cataract. The average age at surgery was 66.8 months (range 14-115 months) and the mean follow-up was 43.4 months (range 12-117 months). At the final visit, there was no significant difference in refractive development between the pseudophakic eyes and the fellow eyes of the subjects. Sixty percent of the pseudophakic eyes had a BCVA of 20/200 or better and 37% had a BCVA of 20/60 or better. Preoperative visual acuity was the only significant factor related to visual outcome. CONCLUSION: Primary intraocular lens implantation in children with unilateral idiopathic cataracts is an effective treatment for visual rehabilitation. The refractive development of the pseudophakic eyes was not significantly different from the fellow eyes.

Clinical characteristics and surgical outcomes of pediatric cataract in Taiwan.

PURPOSE: To report treatment of pediatric patients with cataract, and evaluate the efficiency of different surgical interventions. METHOD: This study comprised a consecutive series of pediatric patients with congenital or developing cataract who received surgery between 1993 and 2002 at Chang Gung Memorial Hospital in Taiwan. Patients' demographics, cataract type, presenting symptoms, surgical intervention, postoperative visual acuity, and follow-up refractive changes were recorded. RESULTS: Three hundred and ninety-nine eyes of 246 children were included; unilateral cataract was present 21.8% of the eyes. The age at surgery was ranged from 1 to 157 months. Eyes were grouped by surgical interventions performed: Group 1 included 98 eyes that had lensectomy. Group 2 included 89 eyes that had lensectomy and secondary intraocular lens implantation. Group 3 included 212 eyes that had lensectomy with primary intraocular implantation. The mean follow up time was 41.3 months. Finally, 23.1% group 1 patients, 42.1% group 2 patients, and 63.4% group 3 patients achieved visual acuity better than 20/60 (P=0.000). Upon analysis with multifactor regression, age at onset (P=0.011) was the only significant factor related to visual outcome. Complications such as after cataract and glaucoma occurred in 21.6% and 5.8% of all patients, respectively. CONCLUSIONS: Intraocular lens implantation for children with congenital or developing cataract is an effective treatment for visual rehabilitation, even for those patients age 2 years and younger.