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Myopic shift after IOL implantation greater in younger children
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Younger children undergoing cataract surgery with IOL implantation experienced the greatest postoperative myopic shift, according to a study.
“There is no common consensus on the optimum target refraction. A detailed discussion with parents and their motivation in complying with contact lens use is important in the determination of target refraction,” the study authors said.
The retrospective study included 32 eyes of 25 Hong Kong Chinese children younger than 18 years who underwent cataract extraction and IOL implantation between 1993 and 2008.
Refractive errors were measured postoperatively at 6 weeks, 3 months, 6 months, 1 year and subsequently on an annual basis.
Mean patient age at the time of surgery was 87 months. Mean follow-up was 50.25 months.
A soft acrylic three-piece IOL was implanted in 18 eyes, and a single-piece PMMA IOL was inserted in 14 eyes.
Study results showed a mean myopic shift of 5.53 D in children 0 to 2 years old, 4.68 D in children 3 to 5 years old, 2.6 D in children 6 to 8 years, 0.42 D in children 9 to 11 years and 0.09 in children older than 11 years.
Between-group differences in total change in refraction and rate of change of refraction were statistically significant (both P < .001).
Myopic shift was significantly greater in patients aged 0 to 2 years at the time of surgery than those aged 6 to 8 years (P = .042), 9 to 11 years (P = .015) or 12 to 17 years (P = .01).
Patients aged 3 to 5 years showed a significantly greater myopic shift than those 12 to 17 years (P = .005).
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