Refractive change in pediatric pseudophakia: 6-year follow-up

Purpose: To evaluate the long-term evolution of refractive error changes in eyes of children who have primary intraocular lens (IOL) implantation to allow more accurate prediction of what IOL power should be implanted at a given age. Setting: Department of Ophthalmology, Indiana University School of Medicine, Indianapolis, Indiana, USA. Methods: This study comprised all children between 2 and 15 years of age who had posterior chamber IOL implantation and who were followed for a minimum of 4 years postoperatively. Thirty-eight eyes of 27 patients with a mean follow-up of 6.1 years were evaluated. All refractions were performed manually by an experienced pediatric ophthalmologist. Results: Children operated on at age 2 or 3 years had a mean myopic shift of 4.60 diopters (D) (range 0.50 to 10.75 D) over a mean of 5.8 years postoperatively. Children operated on at age 6 or 7 years had a mean myopic shift of 2.68 D (range 0.50 to 6.60 D) over a mean of 5.3 years. Children operated on at age 8 or 9 years had a mean myopic shift of 1.25 D (range -0.75 to 2.60 D) over a mean of 6.8 years. Patients operated on between ages 10 and 15 years had a mean shift of 0.61 D (range 0 to 1.90 D) over a mean of 5.7 years. Conclusions: The mean rate of myopic shift decreased throughout childhood, and the range of shift among individuals narrowed as patient age increased. However, the ability to predict future myopic shift for a given individual remains difficult, especially in younger patients.