Indian Journal of Ophthalmology

LETTER TO THE EDITOR
Year
: 2019  |  Volume : 67  |  Issue : 11  |  Page : 1906-

Comments on: Biometric changes in Indian pediatric cataract and postoperative refractive status


Jyotsana Singh, Siddharth Agrawal, Rajat M Srivastava 
 Department of Ophthalmology, King Georges' Medical University, Lucknow, Uttar Pradesh, India

Correspondence Address:
Dr. Siddharth Agrawal
Department of Ophthalmology, King Georges' Medical University, Lucknow, Uttar Pradesh
India




How to cite this article:
Singh J, Agrawal S, Srivastava RM. Comments on: Biometric changes in Indian pediatric cataract and postoperative refractive status.Indian J Ophthalmol 2019;67:1906-1906


How to cite this URL:
Singh J, Agrawal S, Srivastava RM. Comments on: Biometric changes in Indian pediatric cataract and postoperative refractive status. Indian J Ophthalmol [serial online] 2019 [cited 2020 Apr 10 ];67:1906-1906
Available from: http://www.ijo.in/text.asp?2019/67/11/1906/269603


Full Text



We read with interest the article “Biometric changes in Indian pediatric cataract and postoperative refractive status” by Khokharet al.[1] The authors have commendably evaluated the biometric changes in Indian pediatric cataract and this contributes well to the present literature.

We seek information on the following points which would give further clarity to the readers:

Was there any relationship between the laterality of cataract and axial length growth? In some publications of ocular growth and pediatric cataract, laterality is a useful variable in predicting axial length growth.[2],[3] As the authors have data of both unilateral and bilateral cataracts, this would be a useful addition to literature. Moreover, lesser undercorrection is done in unilateral cataracts as there are increased chances of dense amblyopia not only due to laterality but also due to anisometropia and unilateral loss of accommodation following surgery[4]The authors have mentioned first postoperative refraction on day 1 post surgery. Does that mean that on 1st day repeat general anaesthesia (GA) was given? Also the reliability of refraction is expected to be suboptimal taking into account the 1st day effects on (a) cornea—recent incision, suture, and hydration; (b) anterior chamber—presence of air, residual visco elastic, or balanced salt solution; and (c) intraocular pressureWhile the percentage reduction achieved in different groups is clear, which nomogram has been used preoperatively to achieve the same is unclear. Moreover, is it appropriate to use Sanders, Retzlaff, Kraff (SRK) II formula for all axial lengths >17 mm?[5]

Although 6 months follow-up has been mentioned as a limitation, nevertheless this study does cover the crucial period during which the eye is undergoing most rapid phase of axial growth in infants. It would be useful to continue the follow-up of these children to reach more meaningful conclusions.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.

References

1Khokhar SK, Tomar A, Pillay G, Agrawal E. Biometric changes in Indian pediatric cataract and postoperative refractive status. Indian J Ophthalmol 2019;67:1068-72.
2Hoevenaars NED, Polling JR, Wolfs RCW. Prediction error and myopic shift after intraocular lens implantation in paediatric cataract patients. Br J Ophthalmol 2011;95:1082-5.
3Vasavada AR, Raj SM, Nihalani B. Rate of axial growth after congenital cataract surgery. Am J Ophthalmol 2004;138:915-24.
4Lorenz B, Worle J, Friedl N, Hasenfratz G. Ocular growth in infant aphakia. Bilateral versus unilateral congenital cataracts. Ophthalmic Paediatr Genet 1993;14:177-88.
5O'Gallagher MK, Lagan MA, Mulholland CP, Parker M, McGinnity G, McLoone EM. Pediatric intraocular lens implants: Accuracy of lens power calculations. Eye (Lond) 2016;30:1215-20.