Complications in the first year following cataract surgery with and without IOL in infants and older children.

PURPOSE

The optimal role of intraocular lenses (IOLs) in infants remains a controversial topic for many reasons, including concerns about significant complications occurring in young rapidly developing eyes.

METHODS

To assess the number and type of significant complications requiring further intervention occurring in the first postoperative year, we reviewed the records of 15 eyes of 13 infants undergoing lensectomy with posterior chamber IOL and pars plana vitrectomy (PPV)/capsulectomy under 6 months (group A) of age as part of an ongoing prospective study of IOL use in infants. This group was compared with a group of 16 children age 10 months to 5 years undergoing an identical procedure (group B) and a group of 33 infants less than 6 months of age undergoing lensectomy/vitrectomy without IOL (group C).

RESULTS

Thirteen of 15 eyes in group A required additional surgery in the first postoperative year. Twelve of the 15 eyes (80%) developed secondary opacification across the visual axis posterior to the IOL requiring a second PPV and one eye developed pseudophakic glaucoma. Two patients required a third PPV to keep the visual axis clear. In group B, 0 of 16 (P <.0001) developed secondary opacification of the visual axis. In group C, 4 of 33 (12%; P <.0001) developed pupillary opacification in the first postoperative year.

CONCLUSIONS

Intraocular lens implants in infants may be associated with a higher complication rate requiring further surgery during the first postoperative year than is lensectomy/vitrectomy surgery without IOL implant in infants or lensectomy/IOL/vitrectomy surgery in children older than 6 months of age.