Clinical Results of Secondary Intraocular Lens Implantation in Bilateral Congenital Cataract

Abstract

Purpose: To evaluate the long-term visual outcomes of secondary posterior chamber intraocular lens implantation after 2 years of age for bilateral congenital cataract. Methods: A retrospective case review was conducted of 42 pediatric patients who were diagnosed with bilateral congenital cataract and underwent irrigation and aspiration of lenses, posterior capsulectomy, anterior vitrectomy, and after two years of age secondary posterior chamber intraocular lens implantation. Results: The median age at irrigation and aspiration of the lens was 21 weeks; the median age at secondary intraocular lens implantation was 5.5 years; the median age at the last follow-up was 11.1 years. The final visual acuities were 0.42 in the better eye and 0.23 in the fellow eye. The median refractive error at the final follow-up was -2.5 diopters of spherical equivalent, and 1.2 diopters in the amount of astigmatism. For all cases, no posterior capsule opacification, intraocular lens dislocation, or retinal detachment was found. There were 16 postoperative glaucoma patients (19.0%), and their intraocular pressures were well controlled with medical therapy. Conclusions: Secondary posterior chamber intraocular lens implantation performed after two years of age can be an effective therapy for visual development in patients with bilateral congenital cataract undergoing irrigation and aspiration of the lens, posterior capsulectomy, anterior vitrectomy, and aphakic spectacle correction.