Objective To describe baseline characteristics, initial postoperative refractive errors, operative complications, and magnitude of the intraocular lens (IOL) prediction error for refractive outcome in children undergoing lensectomy largely in North America. Design Prospective, registry study of children from birth to <13 years of age having undergone lensectomy for any reason within 45 days preceding enrollment. Participants 1,266 eyes of 994 children; 49% female and 59% white Testing Measurement of refractive error, axial length, and complete ophthalmic examination Main Outcome Measures Eye and systemic associated conditions, IOL style, refractive error, pseudophakic refraction prediction error, operative and perioperative complications Results Mean age at first eligible lens surgery was 4.2 years; 337 (34%) from birth to <1 year of age. Unilateral surgery was performed in 584 (59%) children. Additional ocular abnormalities were noted in 301 (24%) eyes. An IOL was placed in 35 of 460 (8%) eyes when surgery was performed prior to 1 year of age, in 70 of 90 (78%) eyes from 1 to <2 years of age, and in 645 of 716 eyes (90%) from 2 to <13 years of age. The odds of IOL implantation were greater in children ≥2 years of age than those <2 years of age (odds ratio=29.1; p<0.001; 95% confidence interval: 19.6 to 43.3). Intraoperative complications were reported for 69 (5%) eyes, with the most common being unplanned posterior capsule rupture in 14 eyes, 10 of which had an IOL placed. Prediction error of the implanted IOL was <1.00 D in 54% of eyes, but >2.00 D in 15% of eyes. Conclusions Lensectomy surgery was performed throughout childhood, with about two-thirds of cases performed after one year of age. Initial surgery appeared safe with a low complication rate. IOL placement was nearly universal in children 2 years of age and older. The immediate postoperative refraction was within 1 diopter of the target for about one-half of eyes.

Fundoscopic images were consistently obtained using the Pan Optic iExaminer system in the pediatric ED particularly in children 2-18 years of age. CA images were obtained in children less than 2 years old, but less consistently.

IMPORTANCEAlthough the development of self-perception and self-esteem has been investigated in children with strabismic and anisometropic amblyopia, we know little about how self-perception is affected in deprivation amblyopia. Deprivation amblyopia from a dense, unilateral cataract is the least common and typically most severe form of amblyopia. After cataract extraction, optical correction, and patching treatment for amblyopia, visual acuity almost always remains abnormal, and except in rare cases, stereoacuity is nearly always nil.OBJECTIVE To determine whether deprivation amblyopia is associated with altered self-perception in preschool children and to determine whether any differences in self-perception are associated with vision or motor skill deficits. DESIGN, SETTING, AND PARTICIPANTSCross-sectional study conducted from 2016 to 2019 at a pediatric vision research laboratory. Children aged 3 to 6 years were enrolled, including 15 children with deprivation amblyopia and 20 control children.MAIN OUTCOMES AND MEASURES Self-perception was assessed using the Pictorial Scale of Competence and Acceptance for Young Children, which includes 4 specific domains: cognitive competence, peer acceptance, physical competence, and maternal acceptance. Fine motor skills were evaluated with the Manual Dexterity and Aiming & Catching Scales of the Movement ABC-2 test. Visual acuity and stereoacuity also were assessed. RESULTSOf the 35 children included, 13 of 35 were girls (37%) and 28 of 35 were non-Hispanic White (80%). Children with deprivation amblyopia had significantly lower peer acceptance and physical competence scores compared with control children (mean [SD], 2.80 [0.44] vs 3.25 [0.33]; mean difference, 0.45; 95% CI for difference, 0.19-0.71; P = .002 and 2.94 [0.45] vs 3.41 [0.37]; mean difference, 0.47; 95% CI for difference, 0.19-0.75; P = .002, respectively). Among children with amblyopia, moderate associations were found between self-perception domain scores and motor skills, including peer acceptance and manual dexterity (r = 0.68; 95% CI, 0.26-0.89; P = .005), peer acceptance and aiming (r = 0.54; 95% CI, 0.03-0.82; P = .03), and physical competence and aiming (r = 0.55; 95% CI, 0.06-0.83; P = .03).CONCLUSIONS AND RELEVANCE Lower self-perception of peer acceptance and physical competence were associated with early visual deprivation in children in their everyday life.

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