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Ophthalmology. 2016 Dec;123(12):2462-2473. doi: 10.1016/j.ophtha.2016.09.003. Epub 2016 Oct 18.

Cataract Surgery in Children from Birth to Less than 13 Years of Age: Baseline Characteristics of the Cohort.

Author information

1
Wilmer Institute, Baltimore, Maryland. Electronic address: pedig@jaeb.org.
2
Jaeb Center for Health Research, Tampa, Florida.
3
Baylor College of Medicine/Texas Children's Hospital, Houston, Texas.
4
The Emory Eye Center, Atlanta, Georgia.
5
Duke Eye Center, Durham, North Carolina.
6
Children's Mercy Hospitals and Clinics, Kansas City, Missouri.
7
Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois.
8
University of Texas Southwestern, Dallas, Texas.

Abstract

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 who underwent lensectomy for any reason within 45 days preceding enrollment.

PARTICIPANTS:

Total of 1266 eyes of 994 children; 49% female and 59% white.

METHODS:

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%) were <1 year of age. Unilateral surgery was performed in 584 children (59%). Additional ocular abnormalities were noted in 301 eyes (24%). An IOL was placed in 35 of 460 eyes (8%) when surgery was performed before 1 year of age, in 70 of 90 eyes (78%) 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 in those <2 years of age (odds ratio = 29.1; P < 0.001; 95% confidence interval: 19.6-43.3). Intraoperative complications were reported for 69 eyes (5%), 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 diopter in 54% of eyes, but >2.00 diopters in 15% of eyes.

CONCLUSIONS:

Lensectomy surgery was performed throughout childhood, with about two-thirds of cases performed after 1 year of age. Initial surgery seemed 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.

PMID:
27769584
PMCID:
PMC5121052
DOI:
10.1016/j.ophtha.2016.09.003
[Indexed for MEDLINE]
Free PMC Article

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