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A.V. Kumar, M.B. Mets, J.B. Lasky, L.M. Hartemayer; Retrospective Analysis of Pediatric Pseudophakia . Invest. Ophthalmol. Vis. Sci. 2005;46(13):773.
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Purpose: To report refractive changes, best corrected visual acuity, stereopsis, and incidence of amblyopia after cataract surgery with primary intraocular lens implantation. Methods: Retrospective chart review of 32 consecutive patients aged 0–15 years at time of surgery who were operated on by either one of two staff surgeons between 1994 and 2003. The measured outcome was noting how the initial IOL refractive goal of emmetropia at all ages affected the best–corrected visual acuity at the last visit as well as the refractive shift over time. Secondary outcomes included stereopsis and incidence of amblyopia. Results: 42 eyes of 32 patients met inclusion criteria. There were 19 unilateral cataracts and 23 bilateral. Follow–up ranged between 6 months to 6 years. Best corrected visual acuity on the last exam was 20/40 or better in 29 eyes; 35 eyes had BCVA 20/70 (83%). The shift in refractive error over time were as follows: 0–1 year old, –1.00 to –3.75; 2–3 years old, +0.62 to –1.92; 4–5 years old, +0.63 to –4.38; 6–7 years old, +1.00 to –3.63; 8–9 years old, –1.75; 10–15 years old, +0.12 to –2.00. Of the 29 patients with recorded stereopsis, 9 had stereoacuity of 50 seconds of arc or better. 8 of these were bilateral pseudophakes. 18 patients developed some form of amblyopia. Conclusions: An initial IOL refractive goal of emmetropia resulted in good visual acuity in 83% of eyes. Bilateral cataracts resulted in better vision and stereoacuity than unilateral cataracts.
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