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R.A. Walker, K.G. Romanchuk; Long–term Refractive Change After IOL Implantation in Children . Invest. Ophthalmol. Vis. Sci. 2005;46(13):809.
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© ARVO (1962-2015); The Authors (2016-present)
Purpose: To determine the refractive change with age in children who underwent cataract removal with intraocular lens implantation in whom the immediate postoperative refraction was targeted in unilateral cases to match the refractive error in the opposite eye, or for only a small refractive error when surgery was bilateral Methods: Retrospective review of the refractive error over time in 36 eyes of 25 children who underwent cataract removal (11 bilateral) with insertion of an IOL from 1987–1998 and with at least 4 years follow–up, but no glaucoma. Results: Mean age at surgery was 5 1/2 years (median 5 2/3, range 1 1/3 – 12 yrs), with a mean follow–up of 8 years (median 6, range 4 – 18 yrs). The average refraction followed a logarithmic decline with age, with eyes with unilateral surgery having a slightly less rate of change and end result as compared to bilateral surgery, but with variation from the trend in some patients. Conclusions: When we chose to create a small hyperopic refractive error immediately postoperatively, the children usually became significantly myopic when older, often creating anisometropic myopia. When implanting intraocular lenses bilaterally, one should likely aim for a significant but balanced hyperopic correction immediately postoperatively in young patients, anticipating that there will be emmetropization with aging, but warning the parents that variations can occur.
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