IOL presence helps prevent PCO in pediatric patients

PARIS — Posterior capsular opacification is more common in the pediatric population than in adults, but the placement of an IOL helps to limit PCO development, according to a study presented here.

Complication rates can be high after pediatric cataract surgery, said A. Lundvall Nilsson, MD, but part of the reason for that is the length of the follow-up.

“The longer the follow-up after pediatric cataract surgery, the higher the incidence of complications. These patients must have a lifelong follow-up,” she said

Dr. Nilsson and colleagues studied two groups of patients with pediatric cataract; in one group the patients were left aphakic after cataract extraction, and in the other an IOL was implanted. The aphakic group included 83 eyes of 57 children; 31 patients had unilateral surgery, and mean follow-up was 3 years. The IOL group included 31 eyes of 25 children; 25 patients had unilateral surgery, and mean follow-up was 2.5 years. Mean age at the time of surgery was 13 weeks in the aphakic group and 14 weeks in the IOL group.

PCO developed in 32 eyes in the aphakic group and 22 eyes in the IOL group. Pupillary block glaucoma occurred in 11 eyes in the aphakic group and no eyes in the IOL group. Chronic glaucoma occurred in three eyes in the aphakic group and one eye in the IOL group. After an additional 4 years of follow-up, an additional five of the aphakic eyes developed chronic glaucoma.

Risk factors for secondary glaucoma include microcornea, nuclear cataract and persistent fetal vasculature, she said.