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Select criteria aid success of primary IOL implantation in infants

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NASHVILLE, Tenn. — When select criteria are met, primary IOL implantation is relatively safe and successful in children undergoing cataract surgery, according to a poster presentation at the American Association for Pediatric Ophthalmology and Strabismus meeting.

“If they [have] good corneal diameter, no glaucoma, no anterior segment dysgenesis, it’s safe to implant an IOL in kids [younger] than 6 months,” Ramesh Kekunnaya, FRCS, told Healio.com/OSN.

Kekunnaya and colleagues at L.V. Prasad Eye Institute looked at outcomes of 71 eyes of 40 children younger than 6 months of age who underwent lens aspiration, primary posterior capsulorrhexis and anterior vitrectomy with IOL implantation. In 67 patients (94%), the IOL was placed in the capsular bag, in three eyes the IOL was placed in the sulcus and in the bag-sulcus in one eye.

Primary implantation was done in children whose horizontal white-to-white diameter was at least 10 mm without associated anterior segment dysgenesis or increased IOP.

Children were followed for at least 3 years.

“We wanted to look at their visual acuity and we wanted to look at the complications,” Kekunnaya said.

The researchers implanted lenses with an undercorrection of 6 D, and at 3 years the mean myopic shift of 6.02 D resulted in mean spherical equivalent of 0.09. The overall complication rate was 29% at the end of 3 years, with the most common complication being visual axis opacification in 13 eyes (18%), necessitating membranectomy. Overall, secondary surgical intervention was required in 24% of eyes.

“If you implant in [children younger] than 6 months, especially in developing countries like in India where the follow-up is going to be poor, we are better off putting in a lens than not putting in a lens,” Kekunnaya said. – by Patricia Nale, ELS

Reference:

Kekunnaya R, et al. Primary intraocular lens implantation in infants less than 6 months: A long-term outcome. Poster 43 presented at: American Association for Pediatric Ophthalmology and Strabismus annual meeting; April 2-6, 2017; Nashville, Tenn.

Disclosure: Kekunnaya reports no relevant financial disclosures.