Delhi Journal of Ophthalmology

A Retrospective Analysis of Refractive Changes in Pediatric Pseudophakia

Manmitha Reddy Muppidi, Sairani Karanam, Akhil Bevara
Sankara Eye Hospital, Pedakakani, Guntur, Andhra Pradesh, India

Editor-in-Chief, Delhi Journal of Ophthalmology, Dr R.P.Centre, AIIMS.


Corresponding Author:

Manmitha Reddy Muppidi 
MBBS, MS
Sankara Eye Hospital, 
Vijayawada- Guntur Expressway, 
Pedakakani, Guntur, Andhra Pradesh
India
Email id: manmithareddy4@gmail.com


Published Online: 31-JAN-2019
DOI: https://dx.doi.org/10.7869/djo.417

Abstract
Purpose: To evaluate the refractive changes occurring after pediatric cataract surgery with primary Intraocular lens implantation considering several factors to provide an accurate prediction of the IOL power to be selected.
Setting: Sankara Eye Hospital, Pedakakani, Guntur, Andhra Pradesh, India.
Methods: Our study includes 85 eyes of 52 patients of age 2-18 years who underwent cataract surgery with primary IOL implantation. Patients with follow up greater than 6 months were included. The median myopic shift was assessed and compared among various age groups. 
Results: In the 2-5 year age group (17 eyes), the median myopic shift was -1.125 D [Interquartile range (IQR): -3.25, -0.375] over a median follow up of 16 (IQR: 12, 38) months. In the 6-8 year age group (33 eyes), the median myopic shift was -1.125D (IQR: -1.85,-0.625) over a median follow up of 18 (IQR: 12, 33) months. In the 9-11 year age group (14 eyes), median myopic shift was -0.687 D (IQR: -1.625, -0.250) over a median follow up of 11.50 (IQR: 7, 27.75) months. In the 12-18 year age group (21 eyes), the median myopic shift was -0.75 D (IQR: -1.06, -0.25) over a median follow up of 16 (IQR: 7, 25.50) months. The difference of myopic shift between the 4 age groups was statistically significant. In unilateral cases, the operated eye had more myopic shift than the fellow eye and this difference was statistically significant. No statistically significant difference was found in comparing developmental with traumatic cataracts and amblyopic with non-amblyopic eyes. 
Conclusion: Our data shows a decreasing myopic shift as the age progresses in pediatric patients following IOL implantation. We conclude that correcting the eye to emmetropia or mild hypermetropia is a better option, as treating the refractive error that may occur as the age progresses is easier than treating the resultant amblyopia that can occur with under correction at the time of surgery.

Keywords :Myopic shift, Pediatric cataract, Primary Intraocular lens implantation, Complications, Axial length