INTERCAPSULAR LENS IMPLANTATION IN PEDIAT RIC APHAKIA - STUDY OF 87 CASES COMPARED TO 88 CASES WITHOUT LENS IMPLANTATION

Purpose We compared the surgical results and complications between two groups of children operated for cataract with or without lens implant ation. Method One hundred seventy-five eyes in 126 children, aged 15 d ays to 16 years were operated for cataract with a surgical procedure o f limbus phacoaspiration. Eighty-seven received a primary intercapsula r one-piece PMMA Intra Ocular Lens (IOL). Conditions for lens implanta tion were restrictive : strictly intercapsular, no other ocular pathol ogy, at any age in unilateral and usually after 3 years of age in bila teral cataracts. Follow up ranged from 6 months to 10 years. Results P rimary fibrinous anterior chamber reaction was seen in all patients in the IOL group. It always regressed under medical treatment. Glaucoma, retinal detachment and reoperations rates were similar in the two gro ups. There is a high correlation (p < 0.001) between initial anterior vitrectomy and keeping a clear visual axis, even in the eldest group, but no difference with or without IOL. Local tolerance of IOL was eval uated. No effect on visual results was evidenced. Evolution of refract ion in pseudophakic eyes doesn't show evident myopic shift. Secondary myopias found in older groups might be associated to ''genetic'' myopi a more than a consequence of implantation. Conclusion Intercapsular le ns implantation in children does not statistically increase the rate o f complication of cataract surgery. It can be chosen if a real functio nal benefit is expected. The choice of IOL's power depends on biometri c results which are a function of age. Under correction is usually re- commended but immediate emetropia must be the aim in unilateral cases to ease amblyopia's treatment.