Posterior Chamber Lens Implantation in Infants and Juveniles

Abstract

Extracapsular cataract extraction with posterior chamber intraocular lens implantation was performed in 23 eyes (21 patients) of infants and juveniles. Four children with unilateral infantile cataract were operated on at the age of 3 or younger. Nine older children (11 eyes), all of them with bilateral juvenile cataract, were operated when older than 3. Seven children had traumatic cataracts: surgery was performed at the age of 3 or younger in three of them, and above this age in four. One patient aged 13 had a cataract due to heterochromic iridocyclitis. Final visual acuity results, binocularity, surgical complications and the need for additional surgery for secondary cataract development were analysed in relation to the age at surgery and the type of cataract. A visual acuity of 6/12 or better was achieved in 82.6% of the operated eyes. Stereopsis was found in 47.6% of the patients. Inflammation with fibrinous exudate, aqueous flare and cells in the anterior chamber appeared postoperatively in 57% of eyes, and were more common among the infant age group, but subsided with suitable anti-inflammatory treatment. Opacification of the posterior capsule was found within 3 months of surgery in 43.5% of the eyes, and was more common in the infants. Treatment with Nd-YAG laser was useful in the older children; in infants the opening made by laser in the posterior capsule did not last and a clear visual axis was achieved only after pars plana anterior vitrectomy and posterior central capsulectomy. The final results were excellent in patients with juvenile and traumatic cataracts. In those with unilateral infantile cataracts the results were considered encouraging.