Major article
Case series of 12 children with progressive axial myopia following unilateral cataract extraction*

Presented in part at the Annual Symposium of Cataract and Refractive Surgery of the American Society of Cataract and Refractive Surgery Conference, Boston, Massachusetts, May 20-24, 2000
https://doi.org/10.1067/mpa.2002.123658Get rights and content

Abstract

Purpose: We report the occurrence of unilateral progressive axial myopia ipsilaterally in a retrospective analysis of 12 childrenfollowing uniocular cataract surgery. Methods: A retrospective analysis of the case records of children who had developed progressive ipsilateral axial myopia following unilateral cataract surgery was done. Follow-up rangedfrom 4 years to 14 years. Results: Twelve children, 7 male and 5 female, were eligible for the study. Mean age at the time of cataract surgery was 6.7 ± 2.5 years (range, 4-11 years) and follow-up period was 7.8 ± 3.1 years (range, 4-14 years). Ten children (83.3%) had traumatic cataracts of which 8 had undergone repair of penetrating eye injuries and 2 had suffered blunt trauma. Two patients (16.7%)had been operated for unilateral developmental cataracts. Three children had aphakia and nine had pseudophakia. Degree of myopic shift ranged from −4.75 D to −15 D (mean, −7.35 ± 3.51 D). Axial length difference between the 2 eyes ranged from 1 mm to 3.5 mm (mean, 2.2 ± 0.9 mm). Mean increase of axial length from preoperative recording to final follow-up was 2.53 ± 0.90 mm (range, 1.6-4 mm). Three children had to undergo IOL explantation and 1 had posterior chamber intraocular lens exchange due to high unilateral myopia. The rest were visually rehabilitated with either spectacles or contact lenses. Conclusion: Following cataract surgery pediatric eyes may suffer from progressive axial myopia. Trauma or multiple ocular surgeries may be predisposing factors. (J AAPOS 2002;6:228-32)

Section snippets

Patients and methods

A retrospective evaluation of the available records of 12 children who had undergone unilateral cataract surgery and subsequently developed progressive axial myopia was done. Nine cases were operated at our center and 3 cases had been operated outside the center and reported to our lens clinic with poor vision. Over the same period (12 years), a total of 4872 pediatric cataract surgeries had been performed and a total of 2029 children were seen in the lens clinic at our hospital. Most of our

Results

Twelve children (7 male, 5 female) were eligible for the study. Mean age at the time of cataract surgery was 6.7 ± 2.5 years (range, 4-11 years). Ten children (83.3%) had unilateral traumatic cataracts of which 8 had undergone primary repair of penetrating eye injuries and 2 had sustained blunt trauma. Of the latter 2 children, 1 (case 2, Table 1) underwent pars plana lensectomy and a secondary posterior chamber IOL implant 3 months later, and posterior chamber IOL exchange 4 years later, while

Discussion

Gordon and Donzis,15 in their study of the normal refractive development of the human eye, have found that the axial length progressively increases after birth and is within ± 1.0 mm of adult length by 5 to 6 years of age. A rapid postnatal growth phase of 3.7 to 3.8 mm in the first year of life, a slower infantile phase of increase of 1.1 to 1.2 mm up to 5 years of age, followed by a slow juvenile phase of increase of 1.3 to 1.4 mm up to 13 years of age has been described.16 The phenomenon of

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    *

    Reprint requests: Radhika Tandon, MD, FRCOphth, FRCS, Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi 110029.

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