OUTCOME AND COMPLICATIONS OF INTRAOCULAR LENSES IN CHILDREN WITH CATARACT

Purpose: To assess prospectively the complications and changes in refr action, axial length, and keratometry after intraocular lens (IOL) imp lantation in children with congenital, developmental, and traumatic ca taracts. Setting: The Children's Hospital, Dublin, Ireland. Methods: T he study comprised 24 eyes of 20 patients, aged 3 weeks to 12 years, w ho had extracapsular cataract extraction and posterior chamber IOL imp lantation. Mean follow-up was 103 weeks (range 34 to 270 weeks). Resul ts: Six eyes with congenital cataracts operated on between 4 and 28 we eks of age had central, steady, maintained fixation postoperatively. I n the developmental cataract group, 64% achieved a visual acuity of 6/ 24 or better and 43%, 6/12 or better. In the three traumatic cases, vi sual acuities were 6/6, 6/9, and 6/24. Posterior capsule opacification occurred in 95.8% of eyes and was treated with a neodymium:YAG or Zei gler knife posterior capsulotomy as a secondary procedure. Other posto perative complications (membranous uveitis, iris capture, posterior sy nechias, iris prolapse) occurred in 29.2% of eyes. Conclusion: With ca reful management and patient selection, the use of IOLs in children ca n produce good visual results with a minimum of complications. Further follow-up is needed to assess the long-term visual outcome, complicat ions, and changes in refraction.