98th Annual Meeting DOG 2000

P 565

Refractive changes after IOL implantation in childhood

K. Vanselow, C. Rosenkranz, O. E. Schnaudigel, N. Stärk, A. Zubcov

Introduction: Intraocular lens implantation in pediatric cataract patients should take into account how pseudophakia will affect subsequent eye growth and the ultimate refraction.

Method: In a retrospective study the refractive changes of 52 pseudophakic eyes were determined over a mean period of 3 years (6 months to 7 years). 14 patients underwent surgery at age 3-4, 14 patients at age 5-6, 12 patients at age 7-8 and 12 patients were ³ 9years old. Target refraction was +3D at age 3,+2D at age 4,+1D at age 5 and emmetropia from age 6 on. Statistical analysis was performed with the U-test.

Results: In the age groups 3-4 and 5-6 years the mean postoperative refraction was –1D and –1.7D respectively. During the following postoperative years there is a further tendency towards myopia, which however is statistical significant only in the age group 3-4 from the third postoperative year on (p<0.05). The mean postoperative refraction of the older age groups is emmetropic and shows no statistical significant changes during the following years. There is no statistical significant difference in myopic change between amblyopic and non amblyopic eyes and traumatic and non traumatic cataract eyes.

Discussion: In order to avoid myopic changes after cataract surgery in childhood, preoperative assessment should be optimized, the formula should be reevaluated for their validity in the pediatric group and further investigation performed on how pseudophakia influences the emmetropisation process.

Department of Ophthalmology, J. W. Goethe University, Theodor-Stern-Kai 7, D-60590 Frankfurt