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Scott M. Barb, Trey A. Pegram, Natalie Kerr, Mary Hoehn; Comparison of Refractive Error Changes in Children following Intraocular Lens Placement. Invest. Ophthalmol. Vis. Sci. 2011;52(14):6201.
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Few studies have been conducted analyzing the effects of cataract surgery with intraocular lens (IOL) implantation on refractive growth and in children under 12 months of age. This study aims to evaluate the amount of refractive growth in children undergoing cataract surgery with intraocular lens implantation age 1 month to 5.5 years old.
A retrospective chart review was performed for all children undergoing cataract extraction and intraocular lens implantation over a period of 11 years by two surgeons. If bilateral surgery was performed, only the right eye was selected for study. Eighteen children met inclusion criteria, which included a follow-up period of at least 3 years that was 6 months greater than age at surgery (mean age of 1.77 years; range 1 month-5.5 years). Average length of follow-up was 77 months. The total change in post-operative refractive error was analyzed.
The average change in refractive error, final refraction minus initial post-operative refraction, was -6.65 +/- 4.71 diopter (D) with a median change of -5.81D. The change in refractive error in children ages 0-0.5 years at the time of surgery was (-10.79 +/- 4.28), 0.5-2 years (-5 +/- 4.32), and 2-5.5 years (-4.27 +/- 3.04). The difference in change was not statistically significant when comparing the 0-0.5 year group to the 0.5-2 year group and when comparing the 0.5-2 year group with 2-5.5 year group. However, there was a statistically significant difference in change in refractive error between the 0-0.5 age group and the 2-5.5 age group (p=0.006). The follow-up times for the 0-0.5 year age group and the 2-5.5 year age group were (70 +/- 25 months) and (89 +/- 18 months), respectively, which was not a statistcally significant difference (p=0.072).
Cataract extraction with IOL implantation in children between the ages of 0-0.5 years resulted in greater refractive growth than those between the ages 2-5.5 years. Axial length of the eye grows more in the first two years of life than later years, and the effect of an early visually significant cataract has been shown to stimulate axial elongation.
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