August 12, 2011
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Visual outcomes difficult to predict in younger cataract patients

Br J Ophthalmol. 2011;95(8):1082-1085.

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Cataract patients younger than 1 year of age have a higher rate of myopic shift and refractive change per year than older patients, making it harder to predict visual outcomes after IOL implantation, according to a study.

In a retrospective review of 70 eyes of 46 cataract patients who underwent phacoemulsification, three groups were examined. In group A, patients were 0 to 1 years old; in group B, they were 1 to 7 years old; and in group C, they were 7 to 18 years old. Patients underwent a slit lamp exam, dilated funduscopy, retinoscopy, keratometry and biometry preoperatively. Follow-up was at 1 day, 1 week, 4 weeks and 3 months.

Children in group A had a higher myopic shift and a higher rate of refractive change per year than the older patients in groups B and C. The absolute prediction error in group A was 2.09 D. In group B it was 1.08 D and in group C it was 0.88 D, suggesting that predictable visual outcome is better in older patients, the study authors said.

“We found a wide variation in myopic shifts among our patients less than 1 year of age. Both laterality and age at time of IOL influence the myopic shift,” the study authors said.