Refraktive Chirurgie im Kindesalter

BACKGROUND:

A so-called myopic shift after cataract extraction and IOL implantation is known to occur in children. How much is difficult to predict. In this study we report the refractive development in pseudophakic children after primary and secondary IOL implantation.
METHODS:

The refractive change in all patients receiving an IOL-implantation between 2000 and 2008 with a follow-up of a minimum of 6 months was reviewed (6 - 107 months). Rigid or foldable lenses were implanted by the same technique. Refraction postoperatively and at last follow-up was measured. 62 eyes of 41 patients were reviewed. Patients were divided into three groups based on age at time of surgery: 3 - 4 years, 5 - 6 years and 7 - 12 years.
RESULTS:

The mean myopic shift was 2.5 D in both study groups, patients with primary and secondary IOL implantation. In the group with 3 - 4-year-old children mean myopic shift was 1.5 D in primary and 1.0 D in secondary implantations, in the group with 5 - 6-year-old children 2.75 D in primary and 3.25 D in secondary implantations and in the group with 7 - 12-year-old children 2.0 D in both primary and secondary implanted IOLs.
CONCLUSIONS:

We have shown that there are no differences in refractive changes between primary and secondary IOL implantations in our study group. In contrast to other findings we found the lowest myopic shift in the group of 3 - 4-year-old patients. Our results show that a prediction of expected myopic shift in children after IOL implantations remains difficult.