Unilateral Cataract Surgery Research Articles

Prevalence and Risk Factors of Glaucoma Following Pediatric Cataract Surgery with Primary Implantation in Tertiary Eye Hospital, Bangladesh

Background: Glaucoma is a typical side effect of juvenile cataract surgery. According to various research, it seems to have a bimodal occurrence. In Bangladesh, these difficulties constitute a hardship. Objective: In this study our main aim is to evaluate the prevalence and Risk Factors of Glaucoma Following Pediatric Cataract Surgery with Primary Implantation in Tertiary Eye Hospital. Method: This cross-sectional study was carried out at tertiary eye hospital, Bangladesh from August 2021 to June 2022. Where a total of 200 children who underwent unilateral or bilateral cataract surgery with primary IOL implantation in the first year of their life. All eyes presenting with an isolated cataract or an anterior form of persistence of fetal vasculature not requiring posterior vitrectomy or a moderate microphthalmia allowing primary IOL implantation and with a follow-up of >1year were included in the study. Results: During the study, 70% were female and majority were belong to 7-12 years age group, 55%. According to Intraoperative, and Postoperative Characteristics of study group where bilateral cataract was seen in 45% cases followed by 49% cases were capsular bag, 37% cases were sulcus, 46% used trypan bag. Comparing the SG group to the group that did not develop glaucoma, follow-up time was longer (mean 7,5 vs 5.6 years, P<.001), age at surgery was lower (mean 4 vs 5.0 years; P¼.045), reintervention was more frequent (P<.001), and trypan blue was used more frequently (P¼.008). In univariate analysis, the following factors were significantly associated with an increased risk of SG: axial length<16.5 mm, bilateral cataract, perioperative use of trypan blue, additional surgical procedures, and younger age at surgery. Conclusion: We may infer that the risk of SG increases with time, and that SG appears to have a bimodal occurrence, with an estimated linear incidence rate each year. Follow-up should begin quickly after surgery and last for a long time, and clinicians ......

Ocular biometric changes following unilateral cataract surgery in children.

PurposeTo analyze ocular biometric changes following unilateral cataract surgery in children.MethodsA total of 57 children aged under 13 years who underwent unilateral cataract surgery were analyzed. Groups were classified according to their age at surgery: group I (age <3), II (3≤ age <6), III (6≤ age <9), and IV (age ≥9). The myopic shift, axial growth, and corneal curvature changes were compared between the pseudophakic eyes and the fellow phakic eyes.ResultsDuring 7.81 ± 4.39 years, the overall myopic shift (D) and the rate of myopic shift (D/year) were significantly higher at -3.25 ± 3.21 D and -0.45 ± 0.44 D/year in the pseudophakic eyes than -1.78 ± 2.10 D and -0.22 ± 0.29 D/year in the fellow phakic eyes (P = 0.01, 0.004). Group I (-1.14 ± 0.66 vs -0.02 ± 0.45 D/year) and group II (-0.63 ± 0.37 vs -0.31 ± 0.29 D/year) showed significantly higher rate of myopic shift in the pseudophakic eyes than in the phakic eyes. The rate of myopic shift in the pseudophakic eyes decreased in the older age groups (P = 0.001). There was no significant between-eye difference in the changes in axial length and keratometric values postoperatively.ConclusionFollowing unilateral cataract surgery, a significant postoperative myopic shift was noticed in the pseudophakic eyes compared to the fellow phakic eyes in groups under 6 years old. Postoperative myopic shift and the resultant anisometropia should be considered when selecting the optimal power of IOL in young children requiring unilateral cataract surgery.

Outcomes of unilateral cataract surgery in children 7 to 18 years of age: a comparison to younger cohorts

Unilateral cataract surgery in young children often results in a disappointing final visual acuity due to developmental anomalies, surgical complications, and deprivation amblyopia. We previously demonstrated that complications, need for additional intraocular surgery, and adverse events is reduced in children aged 2-7 years undergoing unilateral cataract surgery with primary intraocular lens implantation (IOL) compared to infants and toddlers. The purpose of this study is to evaluate and compare the surgical outcomes of older children, aged 7-18 years, who are typically considered to be outside the amblyopic age range.

Long-term strabismus outcomes after unilateral infantile cataract surgery in the Infant Aphakia Treatment Study

To characterize long-term strabismus outcomes in children in the Infant Aphakia Treatment Study (IATS).

Outcomes of unilateral cataract surgery in children 2-7 years of age: a comparison to surgery in toddlers and infants

To compare outcomes of unilateral cataract surgery in children aged 2-7 years with the outcomes reported in younger children. The medical records of patients who underwent unilateral cataract surgery between the ages of 2-7 years were reviewed retrospectively. Traumatic cataracts and ectopia lentis were excluded. Outcomes were compared to those of the Infant Aphakia Treatment Study (IATS) for infants up to 7 months of age and the Toddler Aphakia and Pseudophakia Study (TAPS) for toddlers between 7-24 months of age who underwent unilateral cataract surgery. A total of 68 children were included, with a mean follow-up of 4.3 years. The proportion of intraoperative complications (7%) was significantly lower than that reported in IATS but not significantly different from that of TAPS. In our older cohort, more children (41%) had visual acuity better than 20/40 compared to infants (23% [P < 0.05]) and toddlers (11% [P < 0.001]), with a final median visual acuity of 20/44. The proportion of adverse events in our older cohort was reduced (7%) compared to that of infants (81%) and toddlers (24%). Additional unplanned intraocular surgeries occurred less often (6%) than in the infant cohort (72%). No patients developed glaucoma. Cataract surgery in slightly older children carries less risk of vision-threatening complications and adverse events compared to infants and results in better visual outcomes than in toddlers. Once the decision is made to pursue surgery on a visually significant cataract, the age of the child should determine which relevant risks are emphasized in the informed consent discussion.

Long-term strabismus outcomes after unilateral infantile cataract surgery in the Infant Aphakia Treatment Study

To characterize long-term strabismus outcomes in children in the Infant Aphakia Treatment Study (IATS). This study was a secondary data analysis of long-term ocular alignment characteristics of children aged 10.5 years who had previously been enrolled in a randomized clinical trial evaluating aphakic management after unilateral cataract surgery between 1 and 6 months of age. In the IATS study, 96 of 109 children (88%) developed strabismus through age 10.5 years. Half of the 20 children who were orthophoric at distance through age 5 years maintained orthophoria at distance fixation at 10.5 years. Esotropia was the most common type of strabismus prior to age 5 years (56/109 [51%]), whereas exotropia (49/109 [45%]) was the most common type of strabismus at 10.5 years (esotropia, 21%; isolated hypertropia, 17%). Strabismus surgery had been performed on 52 children (48%), with 18 of these (35%) achieving microtropia <10Δ. Strabismus was equally prevalent in children randomized to contact lens care compared with those randomized to primary intraocular lens implantation (45/54 [83%] vs 45/55 [82%]; P = 0.8). Median visual acuity in the study eye was 0.56 logMAR (20/72) for children with orthotropia or microtropia <10Δ versus 1.30 logMAR (20/400) for strabismus ≥10Δ (P = 0.0003). Strabismus-in particular, exotropia-is common irrespective of aphakia management 10 years following infant monocular cataract surgery. The delayed emergence of exotropia with longer follow-up indicates a need for caution in managing early esotropia in these children. Children with better visual acuity at 10 years of age are more likely to have better ocular alignment.

Karakteritik Pasien Dan Kategori Gangguan Penglihatan Pra Operasi Dan Pasca Operasi Katarak Berbasis Komunitas Pusat Mata Nasional Rumah Sakit Mata Cicendo

Introduction : The main causes of blindness in the world are cataract. Community-based cataract surgery plays an important role in reducing the burden of cataract blindness. Objective : To describe patient’s characteristic and visual impairment before and after community-based cataract surgery. Methods : This is a retrospective descriptive study with secondary data from community-based cataract surgery by the Community Ophthalmology Installation of National Eye Center Cicendo Eye Hospital from January 2019 to December 2020. Visual impairment is divided into four categories based on WHO classification. Result : There were 3890 patients included. Most of patients were aged 60 to 69 years in 1533 people (39,41%). The most common diagnosis was immature senile cataract in 1826 people (46,94%). Most of patients underwent unilateral cataract surgery using Manual Small Incision Cataract Surgery method and implantation of intraocular lens. The most common category of visual impairment in one eye before surgery was blind, in 3714 eyes (95,48%) and one day after surgery was poor outcome, in 2466 eyes (63,39%). The two-eye blindness before surgery were 1492 people (38,35%) and after surgery were 652 people (16,76%). Sight restoration rate was 26,8%. Conclusion : Most of the patients were aged 60-69 years. The most common diagnosis is immature senile cataract. The category of one eye visual impairment before surgery was mostly blind, after surgery was moderate visual impairment. There number of blind patients was decrease from 38,35% before surgery to 16,76% after surgery.

Article Evaluation of the role of anterior chamber depth changes in determining refractive outcome after cataract surgery

In the present study the function of anterior chamber depth (ACD) changes in determining the refractive outcome after cataract surgery has been studied comprehensively. 210 successive adult patients going through unilateral cataract surgery (phacoemulsification by a single surgeon) were included in this prospective study. Depending on axial length patients were suitably classified into 3 groups: Group 1: &lt;22 xss=removed xss=removed&gt;26 mm (n = 70). Pre-operative and post-operative ACD were assessed on immersion ultrasound. The patients were arbitrarily reclassified into group A (≤1.7 mm) and B (&gt;1.7 mm) based on mean ACD change. Post-operative emmetropic, myopic, or hypermetropic status was also determined in all patients. Mean ACD change in short eyes (Group 1), normal (Group 2), and long (Group 3) eyes was 1.90 mm, 1.75 mm, and 1.45 mm, respectively. The Hyperopic shift was noted when the change in ACD was less than 1.70 mm and Myopic shift was noted when the alteration in anterior chamber depth was more than 1.70 mm. Short eyes were more prone to greater post-operative ACD changes as compared to long eyes. Assessment of pre-operative ACD and its subsequent changes after cataract surgery may help in predicting postoperative refractive error. The lesser amount of change in ACD may result in a hyperopic shift and a higher amount of change would result in a myopic shift. Keywords: Anterior chamber depth, Axial length, Myopia, Hypermetropia, Cataract surgery.

Retrospective evaluation of phacoemulsification and aspiration in 182 eyes: Visual outcomes and CDE-predictive value.

To determine the effect of cumulative dissipated energy (CDE) on complications and visual outcome following cataract surgery in dogs. Records of 182 canine eyes that had undergone cataract surgery. Retrospective medical record review was conducted on dogs that underwent unilateral or bilateral elective cataract surgery by a single surgeon. Preoperative variables such as age, cataract duration, and pre-existing conditions were recorded. Intraoperative variables such as intraocular lens (IOL) status, phacoemulsification time, average power, irrigation fluid volume, and CDE were recorded. Postoperative complications and visual status at last follow-up were compared to these variables. Eighty-six percent of dogs were visual in one or both eyes at last follow-up (LFU) examination. Median follow-up time was 186days postoperatively. Eyes that developed glaucoma had a significantly greater mean CDE (77.73±80.11) than eyes that did not develop glaucoma (49.21±38.93). Eyes that remained visual at the LFU examination had a significantly lower mean CDE (48.31±37.14) than eyes that were blind at LFU (82.05±82.73). Significantly lower mean CDEs were found in diabetic eyes, younger eyes, early-operated eyes (<1month duration), and eyes with preoperative lens-induced uveitis. Higher CDE may be associated with an increased risk of postoperative glaucoma and loss of vision in dogs. Cumulative dissipated energy may be a useful prognostic indicator for success of canine cataract surgery.

Prédictibilité du choix de l’implant, résultats visuels à 1 an et complications de la chirurgie de cataracte chez l’enfant

To measure the refraction 1year after cataract surgery in children as a function of under-correction of the implant power and to evaluate the visual prognosis and possible therapeutic challenges. We conducted a retrospective study of 28children (38affected eyes) who underwent unilateral or bilateral cataract surgery with primary intraocular lens implantation over a one-year period of time. The age at the time of surgery was between 1month and 17years. Ten patients had bilateral cataracts (35%) and 18patients unilateral (65%). Ten patients were between 0and 2years of age, 10patients between 2and 6years of age, and 8patients were over 6years old. 72% of the cataracts were idiopathic. The cataracts were mainly cortico-nuclear (37%). Monocular acuity averaged 0.7LogMAR (2/10) between 2and 6years, and 0.2LogMAR (6.3/10) after 6years. The percentage of under-correction was 31% between 0and 2years, 12.2% between 2and 6years, and 2.3% after 6years, for a mean under-correction of 15.2%. The power of the chosen implant after under-correction was 25diopters on average. One year after surgery, visual acuity averaged 0.2LogMAR (6.3/10) between 2and 6years old,and 0.1LogMAR (8/10) after 6years. The spherical equivalent remained globally stable after surgery (the mean postoperative value was+1.25diopters). The highest rate of revision surgery occurred in the 0-2year-olds (40%). The most common complication was cellular proliferation (up to 80% of the 0-2year-olds). Only one case of ocular hypertension was noted. It is necessary to apply an under-correction of the intraocular lens power, decreasing with the age of the child. The gain in visual acuity is modest, and the main complication is cellular proliferation.

Outcome of cataract surgery with 1 h of preoperative antibiotic regimen: A strategy during COVID-19 Pandemic: Study from a tertiary eye care hospital

Purpose: This study aims to describe the visual and surgical outcomes of 810 eyes of 805 patients who underwent unilateral cataract surgery on the same day with 1 h of preoperative antibiotic regimen. Setting: Tertiary Care Ophthalmic Hospital. Design: Retrospective, descriptive study. Methods: This study comprised of consecutive adult patients who underwent preoperative cataract work up, received 1 h of preoperative antibiotic regimen, and underwent cataract surgery on the same day of consultation with a minimum 3-week follow-up period. This study describes the demographic profile, preoperative, intraoperative details, postoperative (PO) best-corrected visual acuity (BCVA), and surgical outcomes of these patients. Results: 810 eyes of 805 patients with a mean age of 61.0 ± 9.7 years, 50% had systemic and 9% had ocular comorbidities. The mean preoperative BCVA was 0.8 ± 0.7 LogMAR. Phacoemulsification was performed in 90.1%. Intraoperative complications had occurred in 8 (1%) eyes. The mean PO BCVA of the study group on PO day 1 (POD1) and PO 3 weeks was 0.13 ± 0.3 LogMAR and 0.07 ± 0.3 LogMAR, respectively. Our study showed that 95.68% had improvement in vision, while 96.8% achieved BCVA 6/18 or better. None had PO endophthalmitis. Comparison between preoperative and both POD 1 day and PO 3-week BCVA showed statistically significant improvement (P < 0.001). Conclusion: Our study results satisfied the benchmark set by the World Health Organization (WHO) for PO BCVA with good surgical outcome. Preoperative antibiotic applied 1 h before cataract surgery provided safety and comfort and with low risk for endophthalmitis. This strategy can be adopted to tackle the backlog of cataract surgeries due to COVID-19 (or any other emergency situation) in developing countries.

Evaluation of Vision-Related Quality of Life After Unilateral Implantation of a New Trifocal Intraocular Lens.

Objectives:The objective of the study was to evaluate visual performance and subjective quality of life after unilateral implantation of a new trifocal intraocular lens (IOL) in young and middle-aged patients.Methods:Patients that underwent unilateral cataract surgery with implantation of trifocal TFNT00 IOL with an emmetropic fellow eye were included in the study. Vision related daily activity performance was evaluated in postoperative 6th month. Patients were divided in two groups according to the uncorrected near visual acuity of their fellow eyes: İn Group I if worse than the operated eye and in Group II if equal or better than the operated eye. The visual function-14 (VF-14) questionnaire was used with scores of 4 with no difficulty, 3 points with mild difficulty, 2 points with moderate difficulty, 1 point with severe difficulty, and 0 point if unable to perform.Results:Twenty-one patients were enrolled in this study. Patients had good visual performance, showing VF-14 scores above 3 in all categories. Reading small print (3.67±0.48) and driving at night (3.67±0.48) were found to be the most difficult tasks to perform. No significant difference was found between two groups in any category that was investigated by the VF-14 questionnaire.Conclusion:Unilateral implantation of TFNT00 trifocal IOL is well tolerated with good patient satisfaction assessed by VF-14 questionnaire in subjects that have cataract in one eye, encouraging single-eye surgical procedure in this particular group of patients.

Meibomian Gland Morphology Changes After Cataract Surgery: A Contra-Lateral Eye Study.

Purpose: To evaluate the morphology changes of meibomian glands (MGs) after cataract surgery.Setting: Hangzhou Branch of the Eye Hospital of Wenzhou Medical University, Zhejiang, China.Methods: In this contra-lateral eye study, 40 patients received unilateral cataract surgery for age-related cataract. All the patients underwent the evaluation of non-invasive break-up time (NIBUT) and lower tear meniscus height (TMH) before the surgery and 6 months post-operatively. The MGs were evaluated via ImageJ and Meibomian Gland Bio-image Analyzer. MG dropout, length, width, area, gland diameter deformation index (DI), and gland signal index (SI) were recorded.Results: MG length, width, area, DI, and SI were significantly decreased after cataract surgery in the study group (operated eyes, P < 0.001, P = 0.003, P < 0.001, P = 0.001, and P < 0.001, respectively) and showed no significant changes in the control group (non-operated eyes) (all P > 0.05). MG loss increased more in the study group (P = 0.030), and the changes in TMH and NIBUT were not significantly different between the two eyes (both P > 0.05).Conclusion: Cataract surgery aggravated meibomian gland morphology, such as MG loss, MG length, width, area, and SI, and produced no change in NIBUT and TMH at 6 months post-operatively.

Hyaluronic Acid/Trehalose Ophthalmic Solution in Reducing Post-Cataract Surgery Dry Eye Signs and Symptoms: A Prospective, Interventional, Randomized, Open-Label Study.

The purpose of this prospective study was to evaluate the efficacy of the perioperative use of a hyaluronic acid (HA) and trehalose ophthalmic solution (Thealoz® Duo) in reducing post-cataract surgery dry eye signs and symptoms in patients with mild/moderate dry eye disease (DED). One hundred and twenty patients, scheduled for unilateral cataract surgery, were randomized into three groups: (1) group A: HA/trehalose three times/day in the preoperative week and for 5 postoperative weeks; (2) group B: HA/trehalose for only 5 postoperative weeks; (3) group C: no artificial tears. In groups A and B, OSDI (Ocular Surface Disease Index) questionnaire scores were significantly lower than group C at all the postoperative visits; in group A they were significantly lower than group B on the day of surgery, with similar results in the first and fifth weeks after surgery. In groups A and B, break-up time (BUT) was significantly higher than group C during the postoperative period (p ≤ 0.001). In comparison to the preoperative values, BUT in group A remained stable 7 days after surgery; however, in groups B and C, it significantly decreased. In conclusion, the HA/trehalose ophthalmic solution effectively reduced post-cataract surgery DED signs and symptoms in patients with mild/moderate DED, particularly if also administered in the preoperative period.

Does the Aphakic Eye Contribute to the Visual Field with Both Eyes Open?

The uniocular visual fields of phakic eyes were compared to binocular fields of patients post unilateral congenital cataract lensectomy. Despite poor visual acuity outcomes, unilateral cataract removal is important in improving the binocular visual field.

A Case Report of Unilateral Pediatric Cataract Surgery: Posterior Capsule Opacification and Visual Rehabilitation

Objective: To report a case of posterior capsule opacification (PCO) and severe deprivation amblyopia following unilateral pediatric cataract surgery Case Presentation: A 4-year-old girl presented with PCO of the right eye with a history of unilateral congenital cataract surgery and intraocular lens (IOL) implantation without optimal visual rehabilitation two years ago at another hospital in Jakarta. Her uncorrected right eye visual acuity was 3/60 and corrected left eye visual acuity 6/7.5. We performed secondary posterior capsulotomy and anterior vitrectomy of the right eye. Following the procedure, the patient did not regain her vision despite normal posterior segment; thus, a diagnosis of deprivation amblyopia was made. She was prescribed occlusion therapy for 6 hours a day on the left eye to decrease the degree of amblyopia of her right eye. Conclusion: Early identification and management of pediatric cataract surgery complications combined with optimal visual rehabilitation may benefit the patient in the long run. If not treated properly, especially in unilateral cataract cases, it may be too late to regain visual function.

Unilateral cataract surgery outcomes in children 2 to 7 years of age using the STORM Cataract Kids Cohort

Unilateral cataract surgery outcomes in children 2 to 7 years of age using the STORM Cataract Kids Cohort

Endophthalmitis Rate in Immediately Sequential versus Delayed Sequential Bilateral Cataract Surgery within the Intelligent Research in Sight (IRIS®) Registry Data

To compare the rate of postoperative endophthalmitis after immediately sequential bilateral cataract surgery (ISBCS) versus delayed sequential bilateral cataract surgery (DSBCS) using the American Academy of Ophthalmology Intelligent Research in Sight (IRIS®) Registry database. Retrospective cohort study. Patients in the IRIS Registry who underwent cataract surgery from 2013 through2018. Patients who underwent cataract surgery were divided into 2 groups: (1) ISBCS and (2) DSBCS (second-eye surgery ≥1 day after the first-eye surgery) or unilateral surgery. Postoperative endophthalmitis was defined as endophthalmitis occurring within 4 weeks of surgery by International Classification of Diseases (ICD) code and ICD code with additional clinical criteria. Rate of postoperative endophthalmitis. Of 5 573 639 IRIS Registry patients who underwent cataract extraction, 165 609 underwent ISBCS, and 5 408 030 underwent DSBCS or unilateral surgery (3 695 440 DSBCS, 1 712 590 unilateral surgery only). A total of 3102 participants (0.056%) met study criteria of postoperative endophthalmitis with supporting clinical findings. The rates of endophthalmitis in either surgery eye between the 2 surgery groups were similar (0.059% in the ISBCS group vs. 0.056% in the DSBCS or unilateral group; P= 0.53). Although the incidence of endophthalmitis was slightly higher in the ISBCS group compared with the DSBCS or unilateral group, the odds ratio did not reach statistical significance (1.08; 95% confidence interval, 0.87-1.31; P= 0.47) after adjusting for age, sex, race, insurance status, and comorbid eye disease. Seven cases of bilateral endophthalmitis with supporting clinical data in the DSBCS group and no cases in the ISBCS group were identified. Risk of postoperative endophthalmitis was not statistically significantly different between patients who underwent ISBCS and DSBCS or unilateral cataract surgery.

Postoperative stability of refractive error after cataract surgery

Aim. The goal of the present study is to determine how much time must pass after a cataract surgery with no complications to achieve a sufficiently stable refraction. Subjects and methods. We measured the postoperative refraction of 61 pseudophakic subjects (mean age: 74.32 ± 7.11 years) five times with an autorefractor. The subjects had undergone unilateral cataract surgery and the time intervals for the measurement went from one day to eight weeks after the operation. In order to obtain the spherical equiva- lent (SE) and the cylinder power, the difference from each measurement and the last measurement in the seventh or eighth week post-surgery was taken. The Friedman test for paired samples was used to see if there were any significant differences in spherical equivalent and cylinder power in the 5 measurements taken. In addition, two repeated measure- ments were taken on one eye of 16 phakic subjects with good ocular health pertaining to a similar age group to determine the measurement uncertainty of the autorefractor (± 1.96 SD for the measured value differences). Results. In the case of the spherical equivalent, we found no statistically significant difference between the individual re- peated test series. The cylinder power was significantly higher on the first day after the operation than during all subsequent appointments, but then showed no significant difference between all measurements taken during the examinations after the first day. The differences in the spherical equivalent between one measurement and the reference measurement (7 - 8 weeks after the surgery) resulted in 95 % confidence intervals (± 1.96 SD) of approximately ± 2.00 dioptres (D) on the first day post-surgery and lay between ± 1.20 D and ± 0.80 D in post-surgery weeks 1, 3 and 5. The corresponding con- fidence intervals for the cylinder power were ± 2.00 D on the first day post-surgery and lay between ± 1.27 D and ± 0.88 D in post-surgery weeks 1, 3 and 5. The statistical dispersion of the spherical equivalent and the cylinder power decreased slightly as the time from the surgery increased. We estimated a measurement uncertainty for automated refractometry performed on older phakic eyes of ± 0.80 D for the spherical equivalent and ± 1.16 D for the cylinder power. Conclusion. The refractive power of a pseudophakic eye can be determined with sufficient certainty after one to three weeks after undergoing cataract surgery without compli- cations. This means that optical aids to correct any residual refractive error or presbyopia can be prescribed earlier than before and, hence, the number of follow-up appointments required to measure a stable refraction can be reduced. Keywords Cataract, postoperative refraction, refraction measurement, repeated automated refractometry, Intraocular lenses (IOL)

Comparative analysis of visual outcomes of multifocal and monofocal intraocular lenses in congenital cataract surgery.

To assess the impact on visual development of multifocal vs monofocal intraocular lenses (IOLs) implantation in children after congenital cataract surgery. Ophthalmology Department, Bambino Gesù Children's Hospital, Rome, Italy. Retrospective interventional consecutive case series. Records of 56 eyes of 43 pediatric patients who underwent congenital cataract surgery with phacoaspiration and simultaneous implantation of the IOL younger than 1 year were reviewed. Corrected distance visual acuity (CDVA), refractive error, and ocular motility disorders were evaluated at follow-up of greater than 4 years. 32 multifocal (18 unilateral, Group A and 14 bilateral, Group B) and 24 monofocal (12 unilateral, Group C and 12 bilateral, Group D) IOLs were implanted. Mean follow-up was 6.67 years. Mean CDVA of the eyes with multifocal IOLs was 0.75 ± 0.46 logMAR in unilateral cataract surgery and 0.34 ± 0.25 logMAR in bilateral ones; with monofocal IOLs was 0.71 ± 0.52 logMAR in unilateral and 0.53 ± 0.43 logMAR in bilateral ones. No statistically significant difference in the CDVA between Groups A and B and Groups C and D were recorded. Final mean spherical equivalent was -3.88 ± 4.73 diopters (D); in Group A, it was -2.74 ± 4.22 D, in Group C was -1.08 ± 1.45 D, in Group B was -4.82 ± 4.64 D, and in Group D was -6.81 ± 4.61 D. The difference was statistically significant between Groups B and D (P = .01), but not between Groups A and C (P = .14). 26 patients (60.4%) showed postoperative strabismus. Surgical correction occurred more in patients with multifocal IOLs implanted (P = .038). Multifocal IOLs did not show significant advantages in visual development in children after congenital cataract extraction younger than 1 year when compared with monofocal IOLs.