Comparison of the outcome of implantation of hydrophobic acrylic versus silicone intraocular lenses in pediatric cataract: prospective randomized study

Abstract

Objective: To compare the postoperative performance of hydrophobic acrylic and silicone square-edge intraocular lenses in pediatric cataract. Design: Prospective randomized study. Participants: Forty-one eyes of 41 children (age 1 month to 8 years) with congenital or developmental cataract. Methods: Children were randomly divided into 2 groups. All participants underwent phacoaspiration, primary posterior capsulotomy, and anterior vitrectomy. Group A ( n = 21) eyes were implanted with acrylic hydrophobic AcrySof SA60AT intraocular lenses (IOLs), and those of Group B ( n = 20) were implanted with silicone Tecnis Z9000 IOLs. The children were evaluated for anterior chamber reaction, IOL position, posterior capsular opacifica-tion (PCO), intraocular pressure, best-corrected visual acuity (BCVA), corneal status, and refractive errors. Results: Postoperatively, 2 eyes in each group had significant anterior chamber reaction with fibrin membrane formation. IOLs were in the capsular bag in all but 1 eye in both groups. Seven eyes in the acrylic group and 6 eyes in the silicone group achieved visual acuity of 20/40 or better. None of the eyes showed glaucoma. BCVA at 1 year was similar in both groups. In the acrylic hydrophobic group, 14 eyes needed hypermetropic correction and 7 eyes were myopic, and in the silicone group 10 eyes had myopia and 10 eyes had hypermetropia at 1 year postoperatively. PCO at 1 yearfollow-up was more common in eyes implanted with acrylic hydrophobic IOLs (5 eyes) than silicone IOLs (2 eyes). Conclusions: Both square-edge hydrophobic acrylic and silicone IOLs were found to be compatible and safe for use in pediatric cataract surgery with similar visual axis clarity and postoperative outcome.