[Intercapsular implantation in the management of cataract in children. Study of 87 cases and comparison to 88 cases without implantation].

PURPOSE

We compared the surgical results and complications between two groups of children operated for cataract with or without lens implantation.

METHOD

One hundred seventy-five eyes in 126 children, aged 15 days to 16 years were operated for cataract with a surgical procedure of limbus phacoaspiration. Eighty-seven received a primary intercapsular one-piece PMMA Intra Ocular Lens (IOL). Conditions for lens implantation were restrictive: strictly intercapsular, no other ocular pathology, at any age in unilateral and usually after 3 years of age in bilateral cataracts. Follow up ranged from 6 months to 10 years.

RESULTS

Primary fibrinous anterior chamber reaction was seen in all patients in the IOL group. It always regressed under medical treatment. Glaucoma, retinal detachment and reoperations rates were similar in the two groups. There is a high correlation (p < 0.001) between initial anterior vitrectomy and keeping a clear visual axis, even in the eldest group, but no difference with or without IOL. Local tolerance of IOL was evaluated. No effect on visual results was evidenced. Evolution of refraction in pseudophakic eyes doesn't show evident myopic shift. Secondary myopias found in older groups might be associated to "genetic" myopia more than a consequence of implantation.

CONCLUSION

Intercapsular lens implantation in children does not statistically increase the rate of complication of cataract surgery. It can be chosen if a real functional benefit is expected. The choice of IOL's power depends on biometric results which are a function of age. Under correction is usually recommended but immediate emetropia must be the aim in unilateral cases to ease amblyopia's treatment.