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First Author: A.Mete TURKEY
Co Author(s): O. Sayg?l? K. Güngör N. Bekir S. Kimyon
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We aimed to report the incidence of visual axis opasification (VAO) following pediatric cataract surgery with three different intraoculer lenses (IOL) and to determine the relationship between IOL type and VAO.
Gaziantep University, Ophthalmology Department
Children who had underwent congenital or developmental cataract surgery between years 2006 - 2010 were included in our study. The records of the patients were evaluated retrospectively. Eyes which had other structurel abnormalities such as persistent hyperplastic primer vitreous, microphtalmos, coloboma, uveal inflammation or congenital glaucoma were excluded from the study. A clear corneal incision of 2.8 mm was made with the keratome. In order to stain the anterior capsule trypan blue was injected. The dye was then washed with the balanced salt solution. Anterior continuous curvilinear capsulorexhsis and cortical hydrodissection was performed. Lens material was aspirated with irrigation/aspiration mode of phacoemulsificator. Posterior continuous curvilinear capsulorhexis was performed with anterior vitrectomy for all children IOL was implanted in the bag. The corneal incision was closed by 10.0 nylon suture after intracameral sefuroxime injection in all eyes. Postoperatively patients were followed up daily for 2 days, once a week for the next 4 weeks, every 2 months for 6 months, and after that every 6 months. Fundus examination by direct and indirect ophthalmoscopy was used. Postoperative VAO and type of IOL were noted. Differences between VAO and IOLs were tested with the Ki-square test. Statistical significance level was set at p<0.001.
65 eyes of 49 patients in 3 different groups were analyzed according to three different lenses implanted. 33 children had unilateral 16 children had bilateral cataract surgery. Children were aged between 24 - 96 months. Patients were divided into three groups according to the IOL that implanted. Acrysof® MA60BM acrylic IOL was implanted in group A, AMO Sensar® 40e IOL was implanted in group B and Eyecryl® 600 hydrophilic acrylic single piece IOL was implanted in group C. Out of 22 eyes in group A, 10 (45,5%) eyes developed VAO. There was 17 eyes in group B and 7 (41,2%) of them developed VAO. There were 26 eyes in group C and 16 (61,5%) of them developed VAO. There was no significant difference between the three groups for the VAO development (p = 0.353). Although in group C VAO complication rate was higher than the others.
VAO devolopment is one of the most common complications of congenital cataract surgery. Despite the fact that we didn"t find a statistically significant difference between 3 IOLs we think that IOL selection may be an important factor which effects the outcome of pediatric cataract surgery. Further studies with more cases and longer follow up are needed.