Visual results and complications of primary intraocular lens implantation in infants aged 6 to 12 months

Lu, Yi; Ji, Yinghong; Luo, Yi; Jiang, Yongxiang; Wang, Man; Chen, Xu

doi:10.1007/s00417-010-1310-4

Cited by 37 publications

(24 citation statements)

References 30 publications

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“…Primary IOL implantation is the preferred method of optical correction in older children after lensectomy [4, 11]. A large sample study by Solebo et al [12] including 221 children under 2 years of age with congenital or infantile cataract found that IOL implantation was independently associated with better visual outcomes in bilateral but not unilateral cases.…”

Section: Discussionmentioning

confidence: 99%

“…Children with unilateral dense cataract tended to develop strabismus; children with bilateral dense cataract tended to develop nystagmus [4, 9, 29]. Birch et al [9] indicated that congenital cataracts with visual deprivation after more than 1.5 months were associated with a significantly higher risk for strabismus and nystagmus.…”

Section: Discussionmentioning

confidence: 99%

“…However, in some developing countries, because of relatively late detection and diagnosis, poor medical conditions and poor compliance with long-term follow-up, the visual prognosis for patients with pediatric cataract is relatively poor compared with that of patients in developed countries. Some studies [3, 4] have focused on the current situation of pediatric cataract treatment in some parts of China, but few studies with large samples have been reported. The purpose of this study was to evaluate the visual outcomes of dense pediatric cataract surgery between January 2007 and December 2012 at Shandong Provincial Hospital affiliated to Shandong University, a large central medical center in eastern China.…”

Section: Introductionmentioning

confidence: 99%

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Visual outcomes of dense pediatric cataract surgery in eastern China

Ren

Wang

et al. 2017

PLoS ONE

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PurposeTo evaluate the visual outcomes of dense pediatric cataract surgery in eastern China.MethodsMedical records of children who underwent surgery for dense unilateral or bilateral pediatric cataract in Shandong Provincial Hospital between January 2007 and December 2012 were collected. Patients who cooperated with optical correction and aggressive patching of the sound eye and who had a minimum postoperative follow-up of more than 2 years were included. Risk factors for poor visual outcomes were analyzed.ResultsOf the 105 eligible patients (181 eyes), 76 had bilateral cataract, and 29 unilateral. With a mean follow up of 46.77 mo (range 24.0~96.0 mo), the final best corrected visual acuity (BCVA) of 158 eyes were recorded, and 4.43% (7/158) achieved 0.1 logarithm of the minimum angle of resolution (logMAR) or better; 15.19% (24/158) obtained a BCVA between 0.1 logMAR and 0.3 logMAR; 18.99%, (30/158) between 0.3 logMAR and 0.5 logMAR; 46.84% (74/158), between 0.5 logMAR and 1 logMAR; 14.55%, worse than 1 logMAR. The mean BCVA of the patients who underwent lensectomy before 3 months of age was significantly better than that of patients who underwent lensectomy between 3 and 12 months (p = 0.001). In the same lensectomy age groups, the final BCVA of the children in the bilateral and unilateral groups did not differ significantly (P>0.05). Lensectomy after 3 months of age, postoperative complications, strabismus and nystagmus were shown to be risk factors for poor visual outcomes.ConclusionsLensectomy before 3 months of age, IOL implantation, proper managing of postoperative complications, early optical correction and aggressive postoperative patching of the sound eye would increase the final BCVA for patients with dense pediatric cataract.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Visual outcomes of dense pediatric cataract surgery in eastern China

Ren

Wang

et al. 2017

PLoS ONE

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“…in a study on primary IOL implantation in infants aged 6–12 months documented a 26.9% risk of VAO. 24 Trivedi et al . 25 reported that 23.6% of infantile cataract and primary IOL implantation, required reoperation for VAO.…”

Section: Discussionmentioning

confidence: 99%

“…The risk may increase with microcornea, microophthalmos, PFV and younger age. 24 There is some controversy about the protective role of IOL implantation against glaucoma after infantile cataract surgery. For example, a study 29 on infants who underwent cataract surgery in the 1 st year of life, found a 13% chance of glaucoma in pseudophakic eyes compared to a 33% chance of glaucoma in aphakic eyes.…”

Section: Discussionmentioning

confidence: 99%

Visual outcomes and complications of piggyback intraocular lens implantation compared to aphakia for infantile cataract

Joshaghani

Soleimani

Foroutan

et al. 2015

Middle East Afr J Ophthalmol

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Purpose:To evaluate the long-term visual outcomes and complications of the piggyback intraocular lens (IOL) implantation compared to aphakia for infantile cataract.Patients and Methods:In a comparative study from 1998 to 2007, piggyback IOL implantation (piggyback IOL group) was performed for 14 infants (23 eyes) with infantile cataract and 20 infants (32 eyes) who were aphakic (aphakia group) after infantile cataract surgery. Data were collected on logMAR visual acuity, and postoperative complications over a mean follow-up time of 6.2 ± 1.7 years and 5.8 ± 1.7 years.Results:The mean age at surgery was 7.5 ± 0.6 months and 6.0 ± 3.3 months for the piggyback and the aphakic group respectively (P > 0.05). At the last follow-up visit, visual acuity was 0.85 ± 0.73 (median = 0.70, interquartile range = 0.3–1.32) in the piggyback IOL group and 0.89 ± 0.56 (median = 0.86, interquartile range = 0.50–1.24) in the aphakic group (P > 0.05). There was a positive relationship between age and visual outcomes in the aphakic group (r = 0.4, P = 0.04) but not in the piggyback IOL group (P = 0.48). There was no significant difference between the mean myopic shift in the piggyback IOL group (∑5.28 ± 1.06 D) and the aphakic group (∑5.10 ± 1.02 D) (P > 0.05). The incidence of reoperation due to complications in piggyback IOL group was higher than aphakic group (%48 vs. %16, respectively, P ≤ 0.01). However, in patients older than 6 months, this risk was not significantly different compared to the aphakic group.Conclusions:Although piggyback IOL implantation for infantile cataract is optically acceptable as a treatment option, there is no significant difference in visual outcomes compared to aphakia. The incidence in reoperation due to complications in patients aged 6 months or younger is higher than those treated with aphakia.

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Postoperative Glaucoma Following Infantile Cataract Surgery

et al. 2014

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IMPORTANCE Infantile cataract surgery bears a significant risk for postoperative glaucoma, and no consensus exists on factors that may reduce this risk.OBJECTIVE To assess the effect of primary intraocular lens implantation and timing of surgery on the incidence of postoperative glaucoma.DATA SOURCES We searched multiple databases to July 14, 2013, to identify studies with eligible patients, including PubMed, MEDLINE, EMBASE, ISI Web of Science, Scopus, Central, Google Scholar, Intute, and Tripdata. We also searched abstracts of ophthalmology society meetings.STUDY SELECTION We included studies reporting on postoperative glaucoma in infants undergoing cataract surgery with regular follow-up for at least 1 year. Infants with concurrent ocular anomalies were excluded. DATA EXTRACTION AND SYNTHESISAuthors of eligible studies were invited to contribute individual patient data on infants who met the inclusion criteria. We also performed an aggregate data meta-analysis of published studies that did not contribute to the individual patient data. Data were pooled using a random-effects model. MAIN OUTCOMES AND MEASURESTime to glaucoma with the effect of primary implantation, additional postoperative intraocular procedures, and age at surgery. RESULTSSeven centers contributed individual patient data on 470 infants with a median age at surgery of 3.0 months and median follow-up of 6.0 years. Eighty patients (17.0%) developed glaucoma at a median follow-up of 4.3 years. Only 2 of these patients had a pseudophakic eye. The risk for postoperative glaucoma appeared to be lower after primary implantation (hazard ratio [HR], 0.10 [95% CI, 0.01-0.70]; P = .02; I 2 = 34%), higher after surgery at 4 weeks or younger (HR, 2.10 [95% CI, 1.14-3.84]; P = .02; I 2 = 0%), and higher after additional procedures (HR, 2.52 [95% CI, 1.11-5.72]; P = .03; I 2 = 32%). In multivariable analysis, additional procedures independently increased the risk for glaucoma (HR, 2.25 [95% CI,; P = .01), and primary implantation independently reduced it (HR, 0.10 [95% CI, 0.01-0.76]; P = .03). Results were similar in the aggregate data meta-analysis that included data from 10 published articles. CONCLUSIONS AND RELEVANCEAlthough confounding factors such as size of the eye and surgeon experience are not accounted for in this meta-analysis, the risk for postoperative glaucoma after infantile cataract surgery appears to be influenced by the timing of surgery, primary implantation, and additional intraocular surgery.

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Visual results and complications of primary intraocular lens implantation in infants aged 6 to 12 months

Cited by 37 publications

References 30 publications

Visual outcomes of dense pediatric cataract surgery in eastern China

Visual outcomes of dense pediatric cataract surgery in eastern China

Visual outcomes and complications of piggyback intraocular lens implantation compared to aphakia for infantile cataract

Postoperative Glaucoma Following Infantile Cataract Surgery

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