Long-Term Changes in Refraction After Primary Monocular IOL Implantation in Infancy

Sunday, April 19, 2015: 3:46 PM
Room 1B (San Diego Convention Center)
Dina Tadros, MD
Rupal H. Trivedi, MD
M. Edward Wilson, MD

To report refractive shift after primary IOL implantation in patients operated for monocular congenital cataract after 5 or more years of follow up.

Study population: Infants operated for monocular cataract before seven months of age. Inclusion criteria: Unilateral congenital cataract, and Corneal diameter ≥ 9 mm. Exclusion criteria: acquired cataract, persistent fetal vasculature, glaucoma, duration of follow up less than 5 years. For patients undergoing IOL exchange, we calculated refractive shift before and after surgical change of IOL power to calculate total refractive shift.

We reviewed the charts of 50 patients operated for monocular congenital cataract.  We identified 13   patients fulfilling the inclusion criteria. Average age at cataract surgery 2.8 (SD 2.2) months; Average age at final refraction:  10.5 (SD 4.4) years; Duration of follow up: 10.3 (SD 4.4) years.  2 patients underwent IOL exchange due to high myopia. First refraction was performed at median of 10 day.  Initial SE was +7 (SD 2.2, IQR 6 to 8) D; Final refraction SE was -1.9 (SD 2.8, IQR -3.6 to -0.4) D, refractive shift SE -9.8 (SD, 3.9; IQR -13.2 to —6.5).

Infants undergo a myopic shift after cataract surgery. In this study, myopic refractive shift of 10 D was calculated at an average of 10 years of follow-up. These data can be used when selecting an IOL power for a growing infant.