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Shagun Dhaliwal, David McCartney, Kelly Mitchell, Rachel Cooley, Derek Han, Suzette Luke, Lingkun Kong; Long-term Ocular Developmental Changes in Children following Cataract Surgery. Invest. Ophthalmol. Vis. Sci. 2018;59(9):897.
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© ARVO (1962-2015); The Authors (2016-present)
The effect of pediatric cataract surgery, particularly IOL implantation, upon ocular development is a subject of much investigation and debate. We performed a retrospective chart review to compare the ocular biometry characteristics of aphakic and pseudophakic individuals who underwent cataract surgery as children with age matched controls. Our goals were to assess the difference in biometric measurements and to explore the correlation of intraocular pressure and cornea thickness.
This retrospective chart review examined patient data from 2001-2017. We identified 35 aphakic and pseudophakic patients (52 eyes) status post pediatric cataract surgery and 14 age matched control (28 eyes) for comparison. 14 fellow eyes in our unilateral cataract extraction patient group were examined as controls. Patients’ with traumatic cataracts and corneal disease (i.e Peter’s anomaly, sclerocornea) were not included in our data set. Data collected during retrospective chart review included demographics, age and date of surgical intervention(s), visual acuity, intraocular pressure, mean central corneal thickness, keratometry (K), anterior chamber depth (ACD), and axial length (AL). Data were analyzed with IBM SPSS statistic software.
Corneas were thicker in aphakic eyes (691.3 ± 12.6) as compared to pseudophakic eyes (583.8 ± 11.5) and control eyes (565.6 ± 11.1), p=0.000. There was no significant difference in corneal thickness between control eyes and pseudophakic eyes, p=0.2. Corneas of aphakic eyes (42.0 ± 0.8) were more flat than pseudophakic eyes, p=0.02 and were similar to control eyes (43 ± 0.4), p =0.02. The ALs of both aphakic (24.2 ± 0.6) and pseudophakic (23.9 ± 0.4) eyes were longer than control eyes (22.4 ± 0.4), p=0.01 and 0.005 respectively. IOP was correlated with the cornea thickness in aphakic eyes, r=0.4.
Our study suggests that pediatric cataract surgery alters ocular development and IOL implantation does contribute to ocular development. The increased corneal curvature in pseudophakes suggests an unaccounted for source of myopic refractive error. Anticipating these post-operative changes allows for more accurate prediction of refractive outcomes.
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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