Binocular function in pseudophakic children

Abstract

Purpose: There have been few reports on the binocular vision results in bilateral pseudophakic children. The author reports on the results of visual and binocular tests personally performed on patients who had the primary insertion of intraocular lenses following the removal of cataracts in their childhood.

Methods: The author visited 4 different medical centers to perform monocular and binocular tests on 21 patients using the same equipment for sensory testing for binocularity on all patients before the history was abstracted from the clinical records. These patients were selected from a consecutive series and followed up for a minimum of 5 years by their ocular surgeons.

Results: The mean patient age at surgery performed on the first eye was 6 years 4 months. The mean age at the date of the author's examination was 16 years 5 months, and the mean length of follow-up was 10 years 4 months. All but 2 patients had motor alignment within 8 prism diopters of orthotropia at near. Fusion and some stereopsis were found to be present in 15 patients, but only 4 of these patients demonstrated fine (60 seconds of arc or better) stereoacuity. Patients with fine vs gross stereoacuity were compared and found to be similar in type of cataract, age at first surgery, interval between surgeries, and length of follow-up and refraction, but to differ in the quality of best-corrected visual acuity.

Conclusion: Although satisfactory motor alignment, fusion, and some stereopsis are present in the majority of patients, fine stereoacuity is uncommon in pseudophakic children.