Comparison Of Refractive Error And Axial Length Between Primary And Secondary Intraocular Lens Implantation In Children

1. Dr Manju Bhate
2. Bhuvaneshvari Ganeshan
3. Dr Sirisha Senthil
4. Mr Krishnaiah

LV Prasad Eye Institute Hyderabad India

Purpose :
To evaluate the postoperative refraction and axial length in children having primary and secondary intraocular lens implantation

Methods:
Medical records from 1995-2006 were reviewed for children with congenital and developmental cataract who underwent cataract extraction with primary intraocular lens implantation(group 1)before 2 years of age and those who underwent secondary intraocular lens implantation(group 2)after 2 years of age.A minimum follow up of 2 years for refractive change and axial length in both groups was evaluated.
23 eyes in group 1 and 29 eyes in group 2 met the inclusion criteria.The children in secondary intraocular lens group were using aphakic glasses until 2 years of age

Results:
The mean age at cataract extraction was 1.32+/-0.63 years(group1)& 0.58+/-0.42years(group 2),age at secondary implantation was 4.56+/-2.16 years.The mean pre & post operative axial lengths were 20.7+/-1.4mm and 22.3+/-1.2mm for group1;p<0.0001 and were 22.4+/-1.8mm &22.7+/-1.6mm for group 2;p<0.0001.The difference between the groups was insignificant p=0.152.
The mean myopic shift in group1 is 4.8+/-2.5D and in group2 was 2.0+/-3.1D with p=0.001 which was highly significant.
The mean refraction at final followup was -0.63+/-3.4D(0 to -3.50D) and 0.75+/-2.3D(0 to -8.0 D)for groups 1&2 respectively with p of 0.907.The mean visual acuity in logmar is 1.04+/-0.75 &0.59+/-0.54 in group 1&2 respectively with P of 0.070 in Mann-Whitney U test.
The mean followup in years for group1 was 3.81+/-2.20 (2-8 years) &6.79+/-1.89(4-11 years).Mean age in years at final axial length measurement was 4.73+/-2.03(2.2-9 group1)and 6.26+/-2.12(4-8.9 group2).

Conclusion:
Based on our results the children who had primary intraocular lens implantation had significant myopic shift than children who had secondary intraocular lens implantation.