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Intraocular lens exchange for high myopia in pseudophakic children #MMPMID27419831
Kraus CL; Trivedi RH; Wilson ME
Eye (Lond) 2016[Sep]; 30 (9): 1199-203 PMID27419831show ga
Purpose: The purpose of this study was to examine the preoperative factors and postoperative outcomes following intraocular lens (IOL) exchange for high myopia in pseudophakic children. Methods: The medical records of all patients undergoing IOL exchange for high myopia were retrospectively reviewed. Results: A total of 15 eyes were identified that had undergone an IOL exchange for myopic shift. Average age of cataract extraction (CE) was 5.4 months. In all, 10/15 had a unilateral cataract. IOL exchange usually occurred at an average of 6 years following cataract surgery. The average spherical equivalent (SE) of the refractive error at that time was ?9.6 D. Following IOL exchange, SE was ?1.3 D. A two-line reduction in best-corrected visual acuity was observed in 1/13 of our patients for whom pre- and post-exchange data were available. The average axial length (AL) of the eye undergoing the IOL exchange was 24.0?mm, average AL in the non-operative eye was 22.1?mm. On average, the operative eyes grew 4.4?mm and the non-operative eyes 3.02?mm. No adverse events were seen in the operative eyes. Conclusion: Younger age at the time of CE creates a greater likelihood of AL elongation and predisposes a child to myopic shift. IOL exchange should be considered an option to reduce anisometropia and associated aniseikonia to improve visual outcomes. Successful visual rehabilitation and predictable post-exchange refractions were seen with our patients.