Abstract

To address the surgical outcomes of pediatric patients with cataracts associated with posterior lenticonus who required cataract extraction and intraocular lens (IOL) implantation according to preoperative lens status. Department of Ophthalmology, Seoul National University Children's Hospital, Seoul, South Korea. Comparative case series. Patients who had cataract extraction and IOL implantation for posterior lenticonus were divided into 2 groups according to the preoperative lens status. Clinical features and visual outcomes in both groups were comparatively analyzed. Forty-seven eyes of 43 patients were studied. Thirty-five eyes had lens opacities localized to the posterior pole, and 12 eyes presented with total opacity of the lens. Preexisting posterior capsule defect was identified intraoperatively in 11 eyes with total lens opacity. Eyes with preexisting posterior capsule defects more frequently required ciliary sulcus fixation of the IOL (P=.01). The mean follow-up after cataract extraction was 66.9 months ± 35.9 (SD). The mean final corrected distance visual acuity of patients with total opacity (0.37 ± 0.57 logMAR) was better than that of patients with posterior polar opacity (0.56 ± 0.50 logMAR), with borderline significance (P=.05). A preexisting posterior capsule defect, found most often in eyes that presented with total lens opacity, could be an obstacle to capsular bag fixation of the IOL. Posterior lenticonus patients with total lens opacity had marginally significantly better visual outcomes than patients with posterior polar opacity. No author has a financial or proprietary interest in any material or method mentioned.

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