Long-term results of secondary intraocular lens implantation in children under 30 months of age

Koch, Camila Ribeiro; Kara-Júnior, Newton; Serra, Alicia; Morales, Marta

doi:10.1038/s41433-018-0191-3

Cited by 23 publications

(49 citation statements)

References 29 publications

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“…Although the safely of pediatric cataract surgery has improved, postoperative complications are still common in young children 5 because they are more prone to inflammatory reactions. The maintenance of a clear visual axis is important, particularly during the first 2-3 years of life, when children are more susceptible to amblyopia 18. The posterior capsule must be opened during surgery in young children to avoid this complication, and an anterior vitrectomy (AV) may be performed because the epithelial lens cells can also grow in the anterior vitreous.…”

Section: Discussionmentioning

confidence: 99%

Comparison of different surgical approaches for pediatric cataracts: complications and rates of additional surgery during long-term follow-up

Koch

Kara-Júnior

Santhiago

et al. 2019

Clinics

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OBJECTIVES: To compare long-term postoperative complications of pediatric cataract surgery with primary intraocular lens (IOL) implantation associated with posterior capsulotomy (PC) and anterior vitrectomy (AV) between patients treated with a corneal or pars plicata/pars plana approach. METHODS: Children who underwent cataract surgery with in-the-bag primary IOL implantation were divided into two groups according to PC and AV surgical approach: a corneal approach (group 1) and a pars plicata/pars plana approach (group 2). Only patients with a follow-up duration of more than two years were included. Long-term surgical outcomes were retrospectively reported. RESULTS: The mean follow-up period was 10.00±3.13 years. No cases of glaucoma or retinal detachment were reported. The mean age at surgery was 34.57±22.66 months. Forty-six children were included (27 eyes in group 1 and 29 eyes in group 2). The most frequent postoperative complication was corectopia, followed by visual axis opacification. Both complications occurred more frequently in group 1 ( p <0.001). After cataract surgery, the rate of additional surgeries in group 1 was 51.9%, while in group 2, the rate was 27.6% ( p =0.1132). CONCLUSION: The pars plicata/pars plana approach with PC and vitrectomy with primary in-the-bag IOL implantation for pediatric cataracts is a safe procedure.

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Section: Discussionmentioning

confidence: 99%

Comparison of different surgical approaches for pediatric cataracts: complications and rates of additional surgery during long-term follow-up

Koch

Kara-Júnior

Santhiago

et al. 2019

Clinics

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“…In addition to greater inflammation, early cataract surgery increases the risk of glaucoma most likely due to disturbances in the angle and anterior segment, which are not yet well-formed in infants. Solebo et al and Koch et al (6,23) found more cases of glaucoma in children who had undergone surgery prior to 6 months of life and that a young age at the time of surgery was the only factor associated with glaucoma. Trivedi et al (9) showed that the risk of glaucoma was higher in aphakic and pseudophakic eyes of pacients who underwent cataract surgery <4.5 months than older patients.…”

Section: Discussionmentioning

confidence: 97%

Resultados a longo prazo de implante primário de lente intraocular no saco capsular em crianças menores que 24 meses

Koch¹,

Kara-Júnior²,

Santhiago³

et al. 2021

ABO

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The purpose of this study was to analyze the safety of primary intraocular lens implantation in a large number of eyes in children aged <24 months. Methods: The medical records of patients aged 5-24 months, who underwent primary intraocular lens implantation in the capsular bag, were reviewed. A foldable three-piece acrylic intraocular lens was implanted by the same surgeon using a single surgical technique. Patients who had <1 year of follow-up after the surgery were excluded. The main outcome measurements included visual acuity, myopic shift, follow-up complications, and additional surgeries. Results: Sixty-eight patients (93 eyes) were analyzed. The mean age of the patients at the time of surgery was 15.06 ± 6.19 months (range: 5-24 months), and the spherical equivalent 1 month after surgery was 3.62 ± 2.32 D. After 5.67 ± 3.10 years, the spherical equivalent was -0.09 ± 3.22 D, and the corrected distance visual acuity was 0.33 ± 0.33 and 0.64 ± 0.43 logMAR in bilateral and unilateral cases, respectively (p=0.000). The highest myopic shift was observed in infants who underwent surgery at ages 5 and 6 months. The most frequent complications included visual axis opacification and corectopia. Glaucoma and retinal detachment were not reported. Conclusion: Primary in-the-bag intraocular lens implantation in children aged 5-24 months is safe, and is associated with low rates of adverse events and additional surgery.

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“…Of these potentially relevant articles, 176 publications were excluded for various reasons, and 33 publications met the inclusion criteria and were included in this report. These comprised 3 RCTs [44][45][46][47][48][49][50][51][52][53][54][55][56][57][58][59][60][61] and 15 nonrandomized studies, [62][63][64][65][66][67][68][69][70][71][72][73][74][75][76] relevant to research questions 1, 2, 3, and 4. No economic evaluations relevant to research questions 5 and 6 were identified. There were 16 clinical publications and 1 methods publication (which was not included in the overall count) 77 that reported on the same RCT -the Infant Aphakia Treatment Study (IATS).…”

Section: Quantity Of Research Availablementioning

confidence: 99%

“…The RCTs were conducted in the US [44][45][46][47][48][49][50][51][52][53][54][55][56][57][58][59]77 and India. 60,61 The nonrandomized studies were conducted in the US, [63][64][65] Germany, 66 Ireland, 67,68 UK, 69 Latvia, 70 China, 71 India, [72][73][74] France, 75 Brazil, 62 and Korea. 76 There were multiple publications for the IATS, which were published in 2020, 46,50,53 2016, 55,56 2015, 52,59 2014, 45,49,58 2013, 54,57 2012, 51 2011, 47,48 and 2010.…”

Section: Study Characteristicsmentioning

confidence: 99%

Intraocular Lenses for Infants With Aphakia

Team¹

2022

cjht

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This systematic review examined intraocular lens implantation in patients aged 12 months or younger at the time of surgery compared with patients aged 12 months or younger with aphakia treated with contact lenses or glasses. It also examined intraocular lens implantation in patients aged 12 months or younger at the time of surgery (i.e., infants) compared with patients older than 12 months up to 12 years of age at the time of surgery (i.e., children). In total, 18 studies (3 randomized controlled trials and 15 nonrandomized studies) were identified that answered the clinical questions relevant to this review. No relevant studies were identified to inform the cost-effectiveness questions. Visual outcomes (i.e., visual acuity) did not seem to differ between patients aged 12 months or younger at the time of surgery who received intraocular lens implantation and in patients with aphakia treated with contact lenses or glasses. Parenting stress was higher in parents of infants who received intraocular lens implantation at 3 months after surgery compared with parents of infants who were treated with contact lenses; however, this difference was not maintained at 1 year after surgery. In 1 study that examined intraocular lens implantation at different ages, age did not appear to be a significant prognostic factor in poor visual outcomes (i.e., visual acuity defined as > 0.5 logMAR). Regarding safety, infants who underwent intraocular lens implantation experienced more frequent occurrences of complications, such as visual axis opacification, compared with infants with aphakia treated with contact lenses or glasses; therefore, more reoperations to remove the opacification were required. Many infants with aphakia who did not receive intraocular lens implantation eventually required the surgery when they got older. There were limited statistical comparisons available for safety outcomes for intraocular lens implantation in infants at different ages. Overall, the incidence in adverse events was similar between infants and children, except for the number of additional surgeries. In the identified literature, younger patients received more additional surgeries than older patients. The risk of bias in the included studies was high. There were many methodological concerns, including selection bias, reporting issues, statistical issues, and study designs with high risk of bias, such as retrospective cohort studies. Family input regarding patients’ and caregivers’ experiences included reports of stress related to the use of contact lenses and stress about outcomes of the cataract removal and/or intraocular lens implantation and the effect on the child, and emphasized timely treatment to ensure optimal development of the child.

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Long-term results of secondary intraocular lens implantation in children under 30 months of age

Cited by 23 publications

References 29 publications

Comparison of different surgical approaches for pediatric cataracts: complications and rates of additional surgery during long-term follow-up

Comparison of different surgical approaches for pediatric cataracts: complications and rates of additional surgery during long-term follow-up

Resultados a longo prazo de implante primário de lente intraocular no saco capsular em crianças menores que 24 meses

Intraocular Lenses for Infants With Aphakia

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