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A. Kolck, T. Buchner, H. Busse, H. Gerding; Long-term Development of Refraction in Children after IOL-implantation . Invest. Ophthalmol. Vis. Sci. 2003;44(13):4812.
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Purpose: To analyze the development of refraction and other parameters (functional results, complications) in a cohort of paediatric patients after posterior chamber IOL-implantation. Methods: Posterior chamber IOL-implantation was performed in a cohort of 17 paediatric patients (19 eyes) between the age of 27 and 122 months (median 66 months). Mean follow-up time was 92 (29-125) months. Results: Reasons for cataract surgery were traumatic (n=5), congenital/developmental (n=12) or complicated (n=2) cataracts. Most frequent complications were: visually significant secondary cataract (60%), and iris capture (30%). A significant secondary cataract could not be prevented by a primary posterior capsulotomy or capsulorhexis in all cases. Visual acuity improved in 15 eyes (88 %), vision deteriorated in one eye and did not change in another eye. A postoperative visual acuity of at least 20/40 could be achieved in 11/19 eyes (65 %). During follow-up a refractive shift of -8.0 to +4.0 dpt (median -2.75 dpt) developed. The average refractive shift towards myopia was slightly higher than expected (-0.5 to -5.1 dpt, median: 1.8 dpt) according to our previously published theoretical model (Gerding et al. IOVS 1996, 37:1935-6). This difference however was not statistically significant (U-Test, p = 0.19). Conclusion: Favourable functional results can be achieved by IOL implantation in children. The analysis of refractive development of children in this series suggests that IOL-implantation in childhood does not retard the myopic shift in humans in contrast to study results about axial elongation in monkeys.
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