Excellent long-term results of primary implants.
Advances in surgical techniques and the latest generation of IOLs for paediatric cataracts have recently encouraged a broad consensus towards an early approach with primary intraocular lens (IOL) implantation. The age at which it is most appropriate to proceed with IOL implantation is still debated, especially when operating on infants or children aged 1-2 years. In the past, the tendency was to remove cataracts and leave young patients aphakic, rehabilitating them with contact lenses. More recently, there has been a steady increase in the rate of primary IOL implantation in children under 2 years of age with congenital cataracts, although considerable caution has been maintained in children under 6 months of age due to the high incidence of undesirable effects. In the literature, there are not many studies available at the present time on the long-term visual outcomes of paediatric cataracts, so the data from a study conducted at the Advanced Eye Centre in Chandigarh (India), with an eight-year follow-up of primary IOL implantation in children under the age of two.
According to data published by Indian researchers, this surgical procedure is safe and ensures excellent long-term results. The myopic shift is well controlled and the final visual acuity achieved is reasonably good. However, the choice of IOL correction power is very important and must include 3-4 D of hypermetropia for this age group. The procedure must be performed through a posterior primary capsulorhexis with endocapsular implantation of the IOL, combined with the management of amblyopia.
The data in this study are retrospective in nature and do not include children for whom follow-up was not possible, so future prospective clinical trials based on large sample sizes are desirable.
Dr. Carmelo Chines
Direttore responsabile
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