[Intraocular lens implantation in children].

OBJECTIVE: To evaluate the results of primary and secondary implantations of intraocular lenses (IOL) in children--visual acuity, binocular function, resulting refraction and complications after operation.

METHODS: The group comprises 47 eyes of 36 children operated in 1993-1997, aged 5-16 years (mean age of operated children 10.3 years). The follow up period after operation was 18-60 months. The mean follow period was 37 months. Twenty-two primary implantations of posterior chamber IOL were made and 25 secondary implantations, incl. 13 posterior chamber IOL and 12 anterior chamber IOL. From the total number of cataracts 26 were traumatic and 21 congenital (16 bilateral and 5 unilateral).

RESULTS: A visual acuity of 6/12 or better was recorded after operation in 31 (67%) eyes, incl. vision 6/6 in 7 eyes. Vision 6/15 to 6/24 was found in 8 (18%) eyes. Binocular function after operation was recorded in 26 (73%) children. Of these 11 have stereopsis and 15 have fusion I-III. Nine children (27%) do not have binocular functions. Half the eyes have after operation a refraction within the interval +/- 1.0 D SE. Fifteen eyes (33%) are within the range of +/- 2 D SE from emetropy. Eight eyes had a refraction in the interval of +/- 3 D SE during the last check-up examination. The most frequent postoperative complication was a slight (48%) or more serious (23%) inflammatory reaction, decentration of the IOL (23%), and in case posterior capsulotomy was not performed during primary implantation, the complication in almost 8% of eyes was secondary cataract which had to be treated by capsulotomy with a NdYAG laser. One intraocular lens had to be explanted.

CONCLUSION: Implantation of an intraocular lens in children aged 5-16 years is according to the results of postoperative visual acuity and binocular functions a suitable alternative of correction of child aphakia.