Understanding post-operative refractive outcome in pediatrics after IOL implementation: factors and predictors

Int Ophthalmol. 2024 Sep 4;44(1):364. doi: 10.1007/s10792-024-03280-w.

Abstract

Background: In pediatric ophthalmology, calculating intra-ocular lens (IOL) power can be challenging. It is important to predict if the post-surgery refractive error (RE) will meet the intended refractive goal. In this study, we aimed to investigate the factors and predictors influencing RE outcomes in children undergoing IOL implantation.

Methods: This was a retrospective cross-sectional cohort study that involved 47 eyes with congenital cataracts underwent IOL implantation. Each patient underwent follow-up visits at two months and two years' post-surgery. The IOL power calculations were conducted using the Holladay 1 formula, and both the prediction error (PE) and absolute prediction error (APE) were calculated.

Results: The mean age was 6.52 ± 4.61 years, with an age range of 1-15 years. The mean IOL power was 20.31 ± 6.57 D, and the mean post-operative refraction was 1.31 ± 2.65 D. The mean of PE and APE were 0.67 ± 1.77 and 1.55 ± 1.06 D, respectively. Whereas PE was correlated to axial length with an R-value of - 0.29 (P = 0.04). The calculation method had a significant negative relationship with APE and PE, with coefficients of - 1.05 (P = 0.009) and - 1.81 (P = 0.009), respectively.

Conclusion: High astigmatism was associated with greater errors in the refractive outcome. The calculation methods had the most considerable impact on the post-operative RE. The customization of surgical approaches to accommodate individual characteristics is crucial. Further research with diverse subgroups is needed to comprehensively understand the influence of each factor.

Keywords: Calculation method; Intra-ocular lens; Pediatric; Post-operative refractive outcome.

MeSH terms

  • Adolescent
  • Cataract / congenital
  • Cataract / physiopathology
  • Cataract Extraction / adverse effects
  • Cataract Extraction / methods
  • Child
  • Child, Preschool
  • Cross-Sectional Studies
  • Female
  • Follow-Up Studies
  • Humans
  • Infant
  • Lens Implantation, Intraocular* / methods
  • Lenses, Intraocular*
  • Male
  • Postoperative Period
  • Refraction, Ocular* / physiology
  • Refractive Errors* / diagnosis
  • Refractive Errors* / etiology
  • Refractive Errors* / physiopathology
  • Retrospective Studies
  • Visual Acuity* / physiology