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Emi Sanders, William F Astle; Primary intraocular lens implantation in children under 12 months of age.. Invest. Ophthalmol. Vis. Sci. 2018;59(9):168. doi: https://doi.org/.
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© ARVO (1962-2015); The Authors (2016-present)
To evaluate intraocular lens as a primary option in treating children with cataracts under twelve months of age.
A retrospective case series was completed including all patients of one surgeon (WA), treated for primary cataracts under one year of age from 1994-2016 at the Alberta Children’s Hospital (ACH), Calgary Alberta Canada. 74 eyes of 55 children with cataracts were included (36 unilateral, 19 bilateral). 20 eyes had primary cataract surgery elsewhere and were left aphakic (25.7%), 8 of which subsequently had a secondary intraocular lens (IOL) implanted at ACH. 54 primary cataract eyes had a primary IOL placed in-the-bag, including a primary posterior capsulotomy and anterior vitrectomy. Average age at surgery was 3.75 months (range=1.5-11.5months), and average follow-up was 6.39 years (range= 6 months -15 years).
There were no serious adverse events in children who had primary IOL under 12 months of age. Using SPSS V19, Chi squared analysis was performed and primary implantation of an intraocular lens (PIOL) under 1 year was a significantly associated with less post-operative glaucoma in follow up X(1)=0.21.985, p=0.000. In the full cohort, 61.54% of eyes achieved vision of 20/200 or better and 26.92% of eyes had final vision of 20/50 or better. 53.85% of aphakic eyes had vision 20/250 or worse, compared to IOL eyes at 33.3%. A student’s t test was used to determine there was no statistically significant difference in visual outcome recorded in lines of vision for those who underwent PIOL implantation (m=15.85, SD=8.145) and those who did not (m=18.82, SD=7.948), t(56)=1.092, p=0.279. 44.59% of IOL eyes developed secondary membranes requiring secondary surgery. 52% of patients required strabismus surgery. There were no other significant visual or structural complications noted in the cohort.
Final visions overall were better in the IOL group than those eyes left aphakic. There was no glaucoma in the eyes implanted with an IOL. Overall, primary intraocular lens implants in children under the age of 12 months of age are safe and effective long-term, and should be considered as a standard surgical treatment for successfully improving vision in this complex group of patients.
This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.
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