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Management of IOLs in pediatric cataracts
Author(s) -
DEL BUEY MA,
CRISTOBAL JA,
REMON L,
LAVILLA L,
MINGUEZ E,
ASCASO J,
CASAS P,
JIMENEZ B,
PALOMINO C
Publication year - 2011
Publication title -
acta ophthalmologica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.534
H-Index - 87
eISSN - 1755-3768
pISSN - 1755-375X
DOI - 10.1111/j.1755-3768.2011.249.x
Subject(s) - medicine , intraocular lenses , ophthalmology , intraocular lens , microphthalmos , aphakia , cataract surgery , cataracts , cataract extraction , optometry , surgery
Purpose To describe the different possibilities of treatment in pediatric cataract with IOL implantation; analyzing the type of IOL, the position of the haptics AND optic. Methods Children of different ages underwent cataract extraction with intraocular lens implantation. We analyzed age of detection, age at surgery, cooperation of the patients, uni or bilaterality, presence of associated ocular abnormalities. Postoperatively we studied the evolution of the ocular inflamation during the first weeks, avoiding synechiae and membranes formation using oral prednisolone. Also we studied the visual recovery of the pseudophakic eye trying to avoid ambliopya by oclussion therapy of the fellow eye (in case of monocular cataract). Results We obtained our best results by implanting an IOL always if possible, unless there is associated ocular pathology (microphthalmos, iris abnormalities,...). Our choice: In children under 2 years of age monofocal "3 pieces" IOL with haptics in sulcus and the optic in the bag or luxated into the vitreous (power undercorrected in 20%). In children between 2 and 4 years of age "3 pieces" IOL in the bag or with the optic into the vitreous. In older children with good preoperative biometric evaluation and good cooperation, specially in monocular developmental cataract, a great option is the use of multifocal IOLs to improve binocularity. Conclusion In our experience, the best option to manage with pediatric cataract is to implant an IOL after cataract extraction, unless the presence of associated ocular abnormalities make it inadvisable . Visual recovery will be faster than in pediatric aphakic eyes and less "hard". Controversy still persists about the appropiate power of the IOL and how to calculate it.