Long-Term Refractive Changes After Pediatric Cataract Surgery: An Average Follow-up of 15 Years

Purpose

To evaluate long-term refractive changes following pediatric cataract surgery.

Design

Retrospective case series.

Methods

A total of 451 eyes from 273 patients who had undergone cataract surgery at age 6 years or younger (mean 1.8 ± 1.8 years) were analyzed, with a mean follow-up of 15.0 ± 2.5 years (range: 12-18 years). The cohort included 120 cases with bilateral aphakia, 58 cases with bilateral pseudophakia, 40 cases with unilateral aphakia, and 55 cases with unilateral pseudophakia.

Results

In eyes that underwent surgery at or before age 2, the median myopic shift was –8.2 D (interquartile range: –11.0 to –5.0 D) in the bilateral aphakia group and –11.2 D (–16.4 to –6.6 D) in the bilateral pseudophakia group, while the median changes in anisometropia (refractive difference between the operated and healthy contralateral eyes) were –8.0 D (–15.3 to –1.2 D) in the unilateral aphakia group and –10.6 D (–14.8 to –4.4 D) in the unilateral pseudophakia group. In eyes that were operated on after age 2, the median myopic shift was –3.7 D (–6.7 to –0.0 D) in the bilateral aphakia group and –5.7 D (–8.6 to –2.8 D) in the bilateral pseudophakia group, while the median changes in anisometropia were –5.1 D (–8.3 to –2.4 D) in the unilateral aphakia group and –6.5 D (–8.8 to –4.1 D) in the unilateral pseudophakia group.

Conclusions

Refractive changes following pediatric cataract surgery were greater in eyes that underwent surgery at a younger age. In cases operated on at or before 2 years of age, median myopic shifts (in bilateral cases) or anisometropic changes (in unilateral cases) ranged from –8 to –11 D in both aphakic and pseudophakic groups over an average follow-up period of 15 years.