Visual axis opacification after cataract surgery and hydrophobic acrylic intraocular lens implantation in the first year of life

Abstract

Purpose: To report the incidence of visual axis opacification (VAO) requiring surgery after cataract extraction with hydrophobic acrylic intraocular lens (IOL) implantation during the first year of life.

Setting: Storm Eye Institute, Charleston, South Carolina, USA; Iladevi Cataract and IOL Research Center, Ahmedabad, India.

Design: Cohort study.

Methods: Medical records of patients younger than 1 year who had primary posterior capsulectomy, vitrectomy, and in-the-bag hydrophobic acrylic IOL implantation were reviewed. In bilateral cases, 1 eye was randomly chosen. The need for surgery for visually significant VAO was evaluated 12 months after cataract surgery.

Results: Seventy-two eyes were included. The mean age at cataract surgery was 6.0 months. Seventeen eyes (23.6%) required surgery for VAO a mean of 6.2 ± 2.9 months postoperatively. The odds for VAO surgery were 3.5 times greater in eyes of female children than in eyes of male children. For AcrySof MA60AC, SA60AT, SN60AT, or SN60WF IOLs, surgery for VAO was required in 25%, 23%, 23%, and 23% of eyes, respectively. The earliest time between cataract and secondary VAO surgery was relatively later (9.0 months) with the SN60WF IOL than with the MA60AC, SA60AT, or SN60AT IOL (4.4, 2.2, and 2.0 months, respectively).

Conclusions: Nearly 25% of operated eyes of infants required a secondary surgical procedure for VAO; the rate was higher in eyes of female infants but did not differ between IOL models. The data indicate that surgery for VAO is required later in eyes with an SN60WF IOL than in eyes in which other AcrySof IOLs were used.

Financial disclosure: No author has a financial or proprietary interest in any material or method mentioned.