[Show abstract][Hide abstract] ABSTRACT: To evaluate the efficacy and outcome of implantation of a single-piece foldable acrylic intraocular lens (IOL) in children younger than 2 years in the Ukraine.
A total of 31 children from all over the Ukraine with a median age of 11 months (range 2-28 months) underwent cataract surgery with anterior and posterior capsulorhexis, implantation of a single-piece AcrySof SA30AL IOL and anterior dry vitrectomy. Of these, 22 patients attended the last follow-up. Ten patients had follow-up periods of 12 months; 12 had follow-up periods of 18 months. At the postoperative visits, we investigated visual acuity (VA), whether or not the subject had strabismus, lens epithelial cell migration and signs of secondary glaucoma.
The single-piece IOL remained clinically centred in all eyes. No secondary glaucoma was detected. Eleven patients needed surgery for after-cataract. All but two patients achieved better VA after surgery. Many patients suffered from deprivation amblyopia as quite a few cataracts were probably congenital; however, the improvement in VA shows that cataract surgery was worth performing despite the late intervention.
The foldable single-piece acrylic IOL seems to be well tolerated by children aged 0-2 years. No serious complications were seen and no patient developed secondary glaucoma within the follow-up time. However, lens epithelial cells are very lively in this age group.
[Show abstract][Hide abstract] ABSTRACT: To evaluate whether cataract surgery in children should be performed with anterior vitrectomy and to examine the properties of the AcrySof SA30AL intraocular lens (IOL) in the pediatric eye.
Filatov Institute, Odessa, Ukraine.
Cataract surgery was performed in 66 children aged 3 to 15 years. They were randomized to surgery with or without anterior vitrectomy. All eyes were implanted with the single-piece AcrySof SA30AL IOL (Alcon). During the study, the patients who needed surgery for after-cataract had a second surgical procedure. Two years after surgery, the surgical method was evaluated using exact logistic regression. Also, the Evaluation of Posterior Capsule Opacification (EPCO) score was compared between the patients who had surgery for after-cataract and the patients who did not need this. The presence of posterior synechias and centration of the IOL were assessed.
Children in the younger age group (</=62 months at surgery) had surgery for after-cataract more often than children in the older age group (P<.01). Patients who did not receive an anterior vitrectomy had surgery for after-cataract more often (P<.01). Age at surgery and whether an anterior vitrectomy was performed did not significantly affect the EPCO score. The patients who had surgery for after-cataract had a significantly higher EPCO score (P<.001). The IOL remained centered in all eyes; no eye developed posterior synechias.
This prospective study shows that cataract surgery with anterior vitrectomy is advantageous in younger patients concerning after-cataract formation. The AcrySof SA30AL maintains good centration, produces minimal inflammation, and is well tolerated in the pediatric eye.
Journal of Cataract and Refractive Surgery 04/2005; 31(4):757-62. · 2.53 Impact Factor