Primary versus secondary intraocular lens implantation in the management of congenital cataract

Abstract

Aim This study aimed to compare the efficacy of primary intraocular lens (IOL) implantation following removal of congenital cataract in patients with aphakia younger than 2 years of age, followed by secondary implantation after the age of 2 years. Patients and methods This was a comparative prospective study that included patients with congenital cataract (28 eyes) who underwent lensectomy and anterior vitrectomy in the first year of life; 14 eyes were subjected to primary IOL implantation. Fourteen eyes with left aphakia were subjected to visual rehabilitation until the age of 2 years. Secondary implantation was performed and the two groups were followed for 2 years after implantation by a full ophthalmological examination. Results Postoperative significant uveitis occurred in 14.2% of patients in group A and 35.7% of patients in group B; the difference between the two groups was statistically insignificant. Fixation was good in 71% of patients in group A and in 57% of patients in group B; this difference was nonsignificant. Increasing intraocular pressure was noted in four cases in group B that was statistically significant and the diagnosis of glaucoma was confirmed and managed, whereas in group A, none of the cases had an intraocular pressure higher than 18 mmHg. Conclusion Primary IOL implantation was found to be safe and effective in the management of congenital cataract; it leads to lower incidence of complications and better visual outcomes compared with aphakia and secondary IOL implantation.