Session Title: Cataract I
Session Date/Time: Friday 03/02/2012 | 10:30-12:30
Paper Time: 10:36
Venue: Hall 1
First Author: : M.Soleimani IRAN, ISLAMIC REPUBLIC OF
Co Author(s): : M. Joshaghani
Purpose:
To evaluate the long term visual outcomes and complications of piggyback intraocular lens (IOL) implantation compared to aphakia and secondary IOL implantation in patients with infantile cataract.
Setting:
Rassoul Akram Hospital
Methods:
In a comparative study, piggyback IOL implantation was performed for fourteen infants (23 eyes) with infantile cataract from 1999 to 2008. In this group; eleven eyes underwent anterior IOL removal at the expected time. We also evaluated twenty infants (32 eyes) who were candidates for aphakia during infantile cataract surgery. In aphakic group, eight eyes underwent secondary IOL implantation at the time of study, ten eyes were using glasses and fourteen eyes were using contact lens .Visual outcomes defined by log MAR visual acuity and postoperative complications were studied. RESULTS The mean operation age was 6.0±3.3 months and 7.5±0.6 months for the piggyback group and the aphakic group respectively (p>0.05). The first post operative refraction reading at one month in piggyback infants was +0.52±1.58. The Log MAR of visual acuity, in piggyback group, was 0.8 ±0.7at the end of follow up. Eleven eyes were operated for IOL removal at the expected time. Refraction of the eyes undergoing anterior IOL removal was -0.40±3.10. In the aphakic group, the mean logMAR was 0.9±0.6 . Based on the Mann-Whitney and Kruskall-Wallis tests, there was no statistically significant difference in log MAR measurements for these two treatment approaches. The lower age at the operation was associated with better visual outcomes in aphakic group. (p=0.04)( p<0.05 ). In piggyback group, there were eight cases of visual axis opacification, three cases of IOL capture, two cases of membrane formation, two cases of IOL decentration, two cases of glaucoma and one case of retinal detachment. The mean myopic shift at first year was -5.3 and -5.1 in piggyback group and aphakic group respectively.
Conclusions:
Although piggyback IOL implantation for infantile cataract is optically acceptable as a treatment option , there is no significant difference in visual outcomes compared to aphakia, The incidence of complications is higher than those treated with aphakia especially in patients aged 6 months or younger.
Financial Disclosure:
No
