Intra-Ocular Lens Implantation In Children

Abstract

We report the outcome of intra-ocular lens implantation (IOL) in 15 eyes of 15 patients with visually significant cataracts (10 traumatic and 5 developmental). Eleven had posterior chamber lens implants (PCL) and four anterior chamber lends implants (ACL), two among the later group being secondary implants after failed contact lens trials. Eleven patients were males and four females. At the time of operation, age ranged from 3-12 years. Follow up period was 6-24 months. Most significant complications were fibrinous uveitis and capsular thickening. Uveitis was worse in younger patients (aged 3-5 years) and became less virulent with sub-conjunctivial injection of Depomedrol. The marked capsular thickening required capsulotomy in 50% of the cases mostly within six months of operation. Visual outcome was excellent (VA 6/12 or better) in 40%, good (VA 6/24 - 6/12) in 33% fair (VA 6/60- 6/24) in20% and poor (Less than 6/60) in 7% (the eye with macular damage, corneal scarring and early age onset cataract). Best results were obtained in traumatic cases aged 5 years and over, with intact climatic conditions with heat and dust around and socio-economic factors are responsible for failure of contactlens. Two patients required secondary ACLs after poor compliance with contact lenses. Uniocular cataract, traumatic or developmental, in children had till recently been a problem for the parents, ophthalmologists and allied specialities. Left alone the child is left with uniocular vision, leucocoria (cosmetically un-acceptable and a psychological burden on child and parents) with added risk of developing squint sooner or latter by the poorly seeing eyes risk being proportionately worse with earlier age onset of cataract.