Posterior Chamber Implants in Unilateral Congenital and Developmental Cataracts

Abstract

Lens implantation in infant and young children has always been a controversial subject, mainly because there is, as yet, no consensus on the surgical approach or the choice of the lens and its dioptric power. Between June 1983 and June 1989, 45 posterior chamber intraocular lenses (IOLs) were implanted in unilateral congenital and developmental cataract patients aged 2 months to 8 years. Prior to the insertion of the lens, a cataract aspiration followed by an elective posterior capsulotomy and anterior vitrectomy were performed in all the cases. The implants were lathe-cut one-piece PMMA lenses of reduced diameter and were inserted either in the bag remnants or in the ciliary sulcus. For infants and toddlers the power of the inserted IOL was 3 to 6 diopters, less than needed for emmetropia. Spectacles were provided to correct residual refractive error. The best visual results were obtained in the developmental cataract group whereas the congenital cataract patients achieved lower visual acuities.