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[Refractive change and axial growth after bilateral intraocular lens implantation in children with congenital cataract].

OBJECTIVE
To observe refractive change and axial growth in children with bilateral congenital cataract after intraocular lens (IOL) implantation.


METHODS
38 patients (76 eyes) with congenital cataract, who undergone cataract extraction, posterior continuous curvilinear capsulorhexis, anterior vitrectomy and primary IOL implantation in the capsular bag, were included. Patients were divided into four groups based on their age at surgery: 2 - 3 years (group A), 4 - 5 years (group B), 6 - 7 years (group C) and 8 - 12 years (group D). The refraction, axial length and corneal curvature in the follow-up for five years were reviewed. The correlation between best corrected visual acuity (BCVA) and refractive or axial change was analyzed.


RESULTS
The mean myopic shift was -2.06, -1.81, -0.56 and -0.25 D respectively in the four groups (P < 0.01). The axial elongation was 1.21,1.13,0.47 and 0.34 mm respectively (P < 0.01). There was no statistically significant difference among the four groups in corneal curvature preoperatively (P > 0.05) or postoperatively (P > 0.05). 50 eyes (65.8%) had a final BCVA of 0.5 or better. No statistically significant correlation was found between BCVA and refractive change (P > 0.05) or axial growth (P > 0.05).


CONCLUSIONS
Cataract extraction combined with primary anterior vitrectomy and bilateral IOL implantation is safe and effective for bilateral congenital cataract. There is a mild trend of myopic shift postoperatively, and the pattern of axial length is similar to normal eyes. Refractive change and axial growth tend to be stable in older patients. It is recommended to set the immediate postoperative refraction under correction slightly in patients with age 2 - 5 years.