A recent study conducted among children who had undergone bilateral congenital cataract surgery before turning two discovered that the incidence of postoperative complications was comparable between aphakic and pseudophakic eyes. The pseudophakic group, however, had a higher incidence of posterior synechiae and a faster visual rehabilitation than the aphakic group.1
Researchers assessed 60 children regularly for five years post-op, looking closely for signs of glaucoma, visual axis obscuration (VAO) and inflammation (cell deposits and posterior synechiae), in addition to visual acuity.1
Upon completing five years of follow-up, researchers found that the incidence of glaucoma was 16% and 13.8% in the aphakic and pseudophakic groups, respectively. The study suggests that there was a larger difference in the incidence of posterior synechiae, which was “significantly more in pseudophakia group (27.6%) compared to aphakia group (8%).” VAO requiring surgery was observed in 8% and 10.3% of aphakic and pseudophakic eyes, respectively.
“Pediatric ophthalmologists tend to be conservative about IOL implantation in children under two years of age due to concern about potential post-op complications and the fact that the anterior chamber and segment is still growing and developing until age two,” said Leonard J. Press, OD, in a Practice Update commentary on the study. “This trial shows that bilateral IOL implantation after cataract extraction do not add any significant risk for glaucoma or other diseases. Given the more rapid improvement in visual acuity with IOLs as compared with contact lenses or glasses, one suspects this will increasingly become the standard of care.”2
1. Vasavada AR, Vasavada V, Shah SK, et al. Five-year postoperative outcomes of bilateral aphakia and pseudophakia in children up to 2 years of age. Am J Ophthalmol. June 12, 2018. [EPub ahead of print].|
2. Five-year postoperative outcomes of bilateral aphakia and pseudophakia in children up to 2 years of age. PracticeUpdate. June 26, 2018.