Long-Term Refractive Outcomes Following Pediatric Cataract Surgery with Primary IOL Implantation

Arnan  Limmahachai; Thammanoon  Surachatkumtonekul

doi:10.33192/smj.v78i5.280456

Authors

Arnan Limmahachai Department of Ophthalmology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, 10700, Thailand
Thammanoon Surachatkumtonekul Department of Ophthalmology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, 10700, Thailand

DOI:

https://doi.org/10.33192/smj.v78i5.280456

Keywords:

Cataract, Pediatric ophthalmology, Myopic shift

Abstract

Objective: To evaluate long-term refractive outcomes following pediatric cataract surgery with primary intraocular lens (IOL) implantation.

Materials and Methods: A retrospective review was conducted on children younger than 13 years who underwent cataract surgery with primary IOL implantation at Siriraj Hospital between 2000 and 2020, with a minimum follow-up of 5 years. Refractive data were converted to spherical equivalents. Linear mixed models were used to analyze refractive shifts across four age groups (1 to <2.5, 2.5 to <4, 4 to <7, and 7 to <13 years) and identify influencing factors.

Results: The study included 71 eyes of 46 children, with a mean follow-up of 8.74 ± 3.01 years. The mean final refractive change ranged from -5.47 D (95% CI: -7.93, -3.01) in children aged 1 to <2.5 years to -1.33 D (95% CI: -1.99, -0.67) in those aged 7 to <13 years. Overall, only 30.99% of eyes achieved a final refraction within ±1.00 D of emmetropia. Multivariate analysis identified preoperative axial length (P = 0.005) and follow-up duration (P = 0.003) as significant predictors of refractive change.

Conclusion: Younger age at surgery correlates with greater magnitude and variability of myopic shift. Standard guidelines should be adapted to target higher residual hyperopia to achieve optimal long-term emmetropic refraction.

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