Outcome and complications of intraocular lenses in children with cataract

Purpose: To assess prospectively the complications and changes in refraction, axial length, and keratometry after intraocular lens (IOL) implantation in children with congenital, developmental, and traumatic cataracts. Setting: The Children's Hospital, Dublin, Ireland. Methods: The study comprised 24 eyes of 20 patients, aged 3 weeks to 12 years, who had extracapsular cataract extraction and posterior chamber IOL implantation. Mean follow-up was 103 weeks (range 34 to 270 weeks). Results: Six eyes with congenital cataracts operated on between 4 and 28 weeks of age had central, steady, maintained fixation postoperatively. In the developmental cataract group, 64% achieved a visual acuity of 6/24 or better and 43%, 6/12 or better. In the three traumatic cases, visual acuities were 6/6, 6/9, and 6/24. Posterior capsule opacification occurred in 95.8% of eyes and was treated with a neodymium:YAG or Zeigler knife posterior capsulotomy as a secondary procedure. Other postoperative complications (membranous uveitis, iris capture, posterior synechias, iris prolapse) occurred in 29.2% of eyes. Conclusion: With careful management and patient selection, the use of IOLs in children can produce good visual results with a minimum of complications. Further follow-up is needed to assess the long-term visual outcome, complications, and changes in refraction.