Long-Term Visual Outcomes and Complications of Piggyback IOL Implantation Compared With Aphakia for Infantile Cataract
Purpose
To evaluate the long-term visual outcomes and complications of piggyback intraocular lens (IOL) implantation compared to aphakia for infantile cataract.
Methods
In a non-randomized comparative study, piggyback IOL implantation was performed for fourteen infants (23 eyes) with infantile cataract. We also evaluated twenty infants (32 eyes) who were candidates for aphakia during the infantile cataract surgery. Visual outcomes defined by logMAR visual acuity and postoperative complications were studied.
Results
The mean operation age was 7.5±0.6 and 6.0±3.3 months for the piggyback and the aphakic group respectively (p>0.05). The logMAR of visual acuity, in piggyback and aphakic groups, was 0.85±0.73 and 0.89±0.56 at the end of the follow up period, respectively (P>0.05). There was a positive relationship between age and visual outcomes in aphakic group (r=0.4, P=0.04) but this relation was not present in piggyback group (P=0.48). There was not a significant difference between the mean myopic shift in piggyback group (-5.28±1.06) and aphakic group (-5.10±1.02) (P> 0.05).The incidence of reoperation due to complications in piggy back group was higher than aphakic group (48% vs 16%, respectively, P=<0.01). However in patients older than 6 months, this risk showed no significant difference compared to aphakic group.
Conclusion
There was no significant difference in visual acuity between aphakic vs piggyback group but it should be noted that our sample size did not provide enough power to rule out a possible difference. So, better designed studies with higher sample size is needed to confirm or reject our founding. The incidence of reoperation due to complications in patients aged 6 months or younger is higher than those treated with aphakia.