Original articleAccuracy of Intraocular Lens Power Calculation Formulae in Children Less Than Two Years
Section snippets
Materials and Methods
We retrospectively analyzed the records of all children less than 2 years of age who had undergone cataract surgery with primary IOL implantation at our institute between January 1, 2006 and December 2007. We included the patients with a minimum follow-up of 4 weeks. We excluded cases with history of ocular trauma, sulcus fixated IOLs, and evidence of any ocular or systemic abnormality.
Preoperatively, a detailed history and complete ocular examination was done for all children.
Results
During this period, 135 eyes of 88 children with congenital/developmental cataract underwent surgery with primary IOL implantation (phaco-aspiration/lens aspiration with primary posterior capsulotomy with posterior chamber IOL). Of these, we included 128 eyes of 84 children aged below 2 years (4–98 weeks) with a minimum of 6 weeks follow-up. Seven eyes were excluded as a result of insufficient follow-up.
There were 43 girls and 41 boys. The mean (± SD) age at surgery was 11.7 months (range:
Discussion
Modern-day cataract surgery aims at minimizing the postoperative refractive error. In adults, it is generally accepted that less than 5% of the patients have a refractive surprise following an IOL implantation.17, 18 Newer studies have proposed the accuracy to be 99.9% within ±2.00 D of predicted refraction.19, 20 However, the prediction error in pediatric eyes remains much larger.
In adults, regression formulae such as SRK and SRK II have been shown to be less predictable than the theoretical
Ramesh Kekunnaya, MD, FRCS, is an Associate Professor at Jasti V Ramanamma Children's Eye care Centre at LV Prasad Eye Institute, KAR campus, Hyderabad, India. He completed a fellowship training at L V Prasad Eye Institute followed by a Pediatric Ophthalmology and Strabismus Fellowship (AAPOS accredited) at Jules Stein Eye Institute, University of California, Los Angeles, USA. Dr Kekunnaya is a member of the American Academy for Pediatric Ophthalmology and Strabismus (AAPOS) and AAO. His areas
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Cited by (55)
Accuracy of Intraocular Lens Power Calculation in Pediatric Secondary Implantation: In-the-Bag Versus Sulcus Placement
2023, American Journal of OphthalmologyCurrent management of infantile cataracts
2022, Survey of OphthalmologyCitation Excerpt :Furthermore, standard IOL power calculation formulae are less predictable for children with congenital cataract undergoing IOL implantation in the first 5 years of life.221 Some studies have evaluated the predictability of IOL power calculation formulae only in infant eyes.222, 223 Kekunnaya and coworkers evaluated the accuracy of IOL power calculation formulate in 128 eyes of children less than 2 years of age and found the absolute prediction error to be high with all current IOL power calculation formulae but that the SRK II formula was the most predictable.223
Deviations From Age-Adjusted Normative Biometry Measures in Children Undergoing Cataract Surgery: Implications for Postoperative Target Refraction and IOL Power Selection
2022, American Journal of OphthalmologyCitation Excerpt :Other factors such as variation in early postoperative PE, which is highest in young children, can also impact the final refractive status. We recommend use of optical biometry or immersion ultrasound if possible54-56 and a modern theoretic IOL calculation formula that is most appropriate for the parameters of an individual eye.57-63 In addition, when choosing a postoperative target refraction, there are patient factors to consider, in that a different postoperative target may be chosen based on the status of the fellow eye in unilateral cases, or a child's neurodevelopmental or visual acuity status.
Precision of bag-in-the-lens intraocular lens power calculation in different age groups of pediatric cataract patients: Report of the Giessen Pediatric Cataract Study Group
2019, Journal of Cataract and Refractive SurgeryUpdates on managements of pediatric cataract
2019, Journal of Current OphthalmologyPractical pattern of surgical timing of childhood cataract in China: A cross-sectional database study
2019, International Journal of Surgery
Ramesh Kekunnaya, MD, FRCS, is an Associate Professor at Jasti V Ramanamma Children's Eye care Centre at LV Prasad Eye Institute, KAR campus, Hyderabad, India. He completed a fellowship training at L V Prasad Eye Institute followed by a Pediatric Ophthalmology and Strabismus Fellowship (AAPOS accredited) at Jules Stein Eye Institute, University of California, Los Angeles, USA. Dr Kekunnaya is a member of the American Academy for Pediatric Ophthalmology and Strabismus (AAPOS) and AAO. His areas of keen interest are pediatric cataract, complex strabismus, vision development and neuro-opthalmogical disorders. He has authored publications in various peer-reviewed journals, book chapters and is a reviewer for many indexed journals.
Amit Gupta, MS, DNB, is currently a consultant at Jasti V Ramanamma Children's Eye care Centre, LV Prasad Eye Institute, KAR campus, Hyderabad, India. He completed a fellowship in Pediatric Ophthalmology at L V Prasad Eye Institute. His areas of keen interest are amblyopia, paediatric cataract, complex strabismus, retinopathy of premarurity, paediatric lid disorders and neuro-opthalmogical disorders. Dr Gupta has authored publications in various peer-reviewed journals and is a reviewer for British Journal of Ophthalmology, JPOS, and JAAPOS.
See Accompanying Editorial on page 1.