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ORIGINAL ARTICLE
Year : 2018  |  Volume : 66  |  Issue : 8  |  Page : 1088-1093

Long-term outcomes following primary intraocular lens implantation in infants younger than 6 months


1 Department of Pediatric Ophthalmology, Strabismus, and Neuro-Ophthalmology, Jasti V Ramanamma Children's Eye Care Centre, Child Sight Institute, L V Prasad Eye Institute, Hyderabad, Telangana, India
2 Department of Pediatric Ophthalmology, Strabismus, and Neuro-Ophthalmology, Nimmagada Prasad Children's Eye Care Centre, Child Sight Institute, L V Prasad Eye Institute, Visakhapatnam, Andhra Pradesh, India
3 Centre for Clinical Epidemiology and Biostatistics, L V Prasad Eye Institute, Hyderabad, Telangana, India

Correspondence Address:
Dr. Ramesh Kekunnaya
Department of Pediatric Ophthalmology, Strabismus, and Neuro-Ophthalmology, Jasti V Ramanamma Children's Eye Care Centre, Child Sight Institute, L V Prasad Eye Institute, KAR Campus, Hyderabad, Telangana
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/ijo.IJO_182_18

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Purpose: To study the long-term safety profile and visual outcomes of primary intraocular lens (IOL) implantation in infants <6 months of age. Methods: This was a retrospective observational study conducted at a tertiary eye care center in South India. Infants under 6 months meeting the selection criteria who underwent cataract surgery (lens aspiration, primary posterior capsulorhexis, and anterior vitrectomy) with primary IOL implantation between January 2008 and December 2011 and minimum 3-year follow-up were included. Patient demographics, serial refractions, visual acuity, complications, and associated amblyopia/strabismus were reviewed. Visual acuity, myopic shift, and complications were the outcome measures. Results: Sixty-nine eyes of 38 infants (31 bilateral; mean age: 4.6 months) were reviewed. Mean follow-up was 51 months (range: 36–84). Median logMAR best-corrected visual acuity at the final visit was 0.74 (interquartile range [IQR]: 0.50–0.98) in eyes with bilateral cataracts and 0.87 (IQR: 0.60–1.14) in eyes with unilateral cataracts with an average myopic shift of 6.7 diopters over 4.2 years. Most common postoperative complication was visual axis opacification (VAO) (13 eyes, 18%), necessitating membranectomy followed by pigmentary IOL deposits (11 eyes, 15%), and IOL decentration and glaucoma in four eyes each (5.6%). Mixed linear effect model found no significant association of age, gender, laterality, and postoperative complications with final visual acuity (P ≥ 0.05). Eyes with unilateral cataracts had a greater myopic shift than bilateral cases (P = 0.03). Conclusion: Primary IOL implantation in infants <6 months is reasonably safe in appropriately selected infants. VAO was the most common postoperative complication, and a large myopic shift was observed.


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