A comparison of the rate of refractive growth in pediatric aphakic and pseudophakic eyes

Objective: To compare the rate of refractive growth in pseudophakic childre n's eyes to that of aphakic eyes. Design: Multicenter, retrospective observational case series. Participants: 83 patients with pseudophakic eyes (100 eyes) and 74 patients with aphakic eyes (106 eyes), with an age of surgery between 3 months and 10 years and a minimum follow-up time of 3 years or more, depending on the age at surgery. Methods: A logarithmic model was used to analyze the rate of refractive gro wth for each eye. Main Outcome Measures: Age at surgery, intraocular lens power, intraocular lens A-constant, initial postoperative refraction, final refraction, and fi nal age. Results: Overall, pseudophakic eyes showed a lesser rate of refractive grow th than aphakic eyes (-4.6 diopter vs. -5.7 diopter, P = 0.03). This trend was also present but less significant when the eyes were grouped into those less than 6 months of age at surgery (-3.3 diopter vs. -4.6 diopter, P = 0 .09) and older patients (-5.0 diopter vs. -6.1 diopter, P = 0.07). However, the mean quantity of myopic shift was greater in pseudophakic eyes than in aphakic eyes (-5.26 diopter vs. -4.54 diopter), despite shorter follow-up times in the pseudophakic eyes. This is due to the optical effects of a con stant intraocular lens power in a growing eye. Conclusions: Pediatric pseudophakic eyes have a slightly lesser rate of ref ractive growth than aphakic eyes. The new rate values should be used for pr edicting future refractions in these eyes. Ophthalmology 2000;107.. 118-122 (C) 2000 by the American Academy of Ophthalmology.