The Optics of Aphakic and Pseudophakic Eyes in Childhood

McClatchey, Scott K.; Hofmeister, Elizabeth M.

doi:10.1016/j.survophthal.2009.07.001

Cited by 52 publications

(37 citation statements)

References 18 publications

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“…Because most growth in a child’s eye occurs in the posterior segment, an IOL implanted during infancy will be farther from the retina as the eye grows, resulting in a larger myopic shift than would be experienced for an aphakic eye with the same amount of axial elongation. 21 …”

Section: Discussionmentioning

confidence: 99%

Comparison of the rate of refractive growth in aphakic eyes versus pseudophakic eyes in the Infant Aphakia Treatment Study

Lambert¹,

Cotsonis²,

DuBois³

et al. 2016

Journal of Cataract and Refractive Surgery

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PURPOSE To compare the rate of refractive growth between aphakic eyes and pseudophakic eyes in the Infant Aphakia Treatment Study (IATS). SETTING Twelve clinical sites across the United States. DESIGN Randomized clinical trial. METHODS Patients randomized to unilateral cataract extraction with contact lens correction versus intraocular lens (IOL) implantation in the IATS had their rate of refractive growth (RRG3) calculated based on the change in refraction from the 1-month postoperative examination to age 5 years. The RRG3 is a logarithmic formula designed to calculate the rate of refractive growth in children. Two-group t tests were used to compare the mean refractive growth between the contact lens group and IOL group and outcomes based on age at surgery and visual acuity. RESULTS Longitudinal refractive data were studied for 108 of 114 patients enrolled in the IATS (contact lens group, n = 54; IOL group, n = 54). The mean RRG3 was similar in the contact lens group (−18.0 diopter [D] ± 11.0 [SD]) and the IOL group (−19.0 ± 9.0 D) (P = .49). The RRG3 value was not correlated with age at cataract surgery, glaucoma status, or visual outcome in the IOL group. In the aphakia group, only visual outcome was correlated with refractive growth (P = .01). CONCLUSIONS Infants’ eyes had a similar rate of refractive growth after unilateral cataract surgery whether or not an IOL was implanted. A worse visual outcome was associated with a higher rate of refractive growth in aphakic, but not pseudophakic, eyes.

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Section: Discussionmentioning

confidence: 99%

Comparison of the rate of refractive growth in aphakic eyes versus pseudophakic eyes in the Infant Aphakia Treatment Study

Lambert¹,

Cotsonis²,

DuBois³

et al. 2016

Journal of Cataract and Refractive Surgery

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“…We did not identify any relationship with a particular eye characteristic correlating with higher prediction error for individual formulae; rather, when higher prediction error occurred, it tended to occur across formulae. A typical rate of refractive growth for an infant eye based on age (in months) 13,22 would result in a 0.4- to 0.7-D myopic shift by the 1-month postoperative refraction, with slower but continued shifts after the first year and anticipation of low to moderate myopia by the second decade. Thus, normal eye growth of an infant during the early postoperative period may contribute to prediction error across formulae.…”

Section: Discussionmentioning

confidence: 99%

Predictability of Intraocular Lens Power Calculation Formulae in Infantile Eyes With Unilateral Congenital Cataract: Results from the Infant Aphakia Treatment Study

VanderVeen

Trivedi

Nizam

et al. 2013

American Journal of Ophthalmology

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PURPOSE To compare accuracy of intraocular lens (IOL) power calculation formulae in infantile eyes with primary IOL implantation. DESIGN Comparative case series. METHODS The Hoffer Q, Holladay 1, Holladay 2, Sanders-Retzlaff-Kraff (SRK) II, and Sanders-Retzlaff-Kraff theoretic (SRK/T) formulae were used to calculate predicted postoperative refraction for eyes that received primary IOL implantation in the Infant Aphakia Treatment Study. The protocol targeted postoperative hyperopia of +6.0 or +8.0 diopters (D). Eyes were excluded for invalid biometry, lack of refractive data at the specified postoperative visit, diagnosis of glaucoma or suspected glaucoma, or sulcus IOL placement. Actual refraction 1 month after surgery was converted to spherical equivalent and prediction error (predicted refraction – actual refraction) was calculated. Baseline characteristics were analyzed for effect on prediction error for each formula. The main outcome measure was absolute prediction error. RESULTS Forty-three eyes were studied; mean axial length was 18.1 ± 1.1 mm (in 23 eyes, it was <18.0 mm). Average age at surgery was 2.5 ± 1.5 months. Holladay 1 showed the lowest median absolute prediction error (1.2 D); a paired comparison of medians showed clinically similar results using the Holladay 1 and SRK/T formulae (median difference, 0.3 D). Comparison of the mean absolute prediction error showed the lowest values using the SRK/T formula (1.4 ± 1.1 D), followed by the Holladay 1 formula (1.7 ± 1.3 D). Calculations with an optimized constant showed the lowest values and no significant difference between the Holladay 1 and SRK/T formulae (median difference, 0.3 D). Eyes with globe AL of less than 18 mm had the largest mean and median prediction error and absolute prediction error, regardless of the formula used. CONCLUSIONS The Holladay 1 and SRK/T formulae gave equally good results and had the best predictive value for infant eyes.

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“…The rate of myopic progression was defined as the total myopic shift per year of observation over the 6 years observation period. The RRG which was proposed by McClatchey and Hofmeister,25 was introduced to reflect the logarithmic nature of refractive growth.…”

Section: Methodsmentioning

confidence: 99%

“…Also from the perspective of ocular biometric measurements, enlargement of globe size is usually completed by approximately 13 years of age 24. Since the natural refractive growth, which shows a tendency towards myopic shift, follows the logarithmic model with regards to the child's age,25 the extent of refractive change decreases with advancing years. Even in childhood age, younger children show a greater change in refractive error status and axial length of globe when compared with older teenagers 26–28.…”

Section: Introductionmentioning

confidence: 99%

The impact of intermittent exotropia and surgery for intermittent exotropia on myopic progression among early school-aged children with myopia

et al. 2014

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The Optics of Aphakic and Pseudophakic Eyes in Childhood

Cited by 52 publications

References 18 publications

Comparison of the rate of refractive growth in aphakic eyes versus pseudophakic eyes in the Infant Aphakia Treatment Study

Comparison of the rate of refractive growth in aphakic eyes versus pseudophakic eyes in the Infant Aphakia Treatment Study

Predictability of Intraocular Lens Power Calculation Formulae in Infantile Eyes With Unilateral Congenital Cataract: Results from the Infant Aphakia Treatment Study

The impact of intermittent exotropia and surgery for intermittent exotropia on myopic progression among early school-aged children with myopia

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