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Pediatric primary IOL implantation challenging but possible
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STOCKHOLM, Sweden — Cataract surgery and primary IOL implantation in children younger than 2 years of age is safe, although it is associated with a high incidence of visual axis opacification requiring additional surgery, according to a study presented here.
Anju Rastogi, MD, and N.R. Bamrolia, MD, evaluated outcomes for 30 eyes of 30 children younger than 2 years of age who were treated for visually significant congenital cataract. Dr. Rastogi discussed the results at the European Society of Cataract and Refractive Surgeons meeting.
The researchers randomly assigned eyes to one of two treatment groups. The first group of 15 eyes underwent surgery involving anterior and posterior continuous curvilinear capsulorrhexis and anterior vitrectomy. Surgeons then implanted an acrylic foldable IOL in-the-bag. The second group of 15 eyes received an acrylic foldable IOL implanted in the ciliary sulcus after undergoing pars plana lensectomy and anterior vitrectomy, according to the study.
All children had at least 6 months of follow-up.
Drs. Rastogi and Bamrolia found that most eyes — 29 of 30 — had an improvement in fixation. However, four of 15 eyes (26.66%) in each group developed visual axis opacification at an average of 10 weeks postop and required pars plana membranectomy, Dr. Rastogi said.
Uveitis was the most common complication and was experienced by 60% of eyes in the first group and 53.3% of eyes in the second group. In all cases, the uveitis had resolved by 1 month follow-up.
"Primary IOL implantation in children less than 2 years of age is feasible and safe," Dr. Rastogi said.