Myopic Shift over 5 Years after Pediatric Lensectomy with Primary Intraocular Lens Implantation.

Autor:	de Alba Campomanes AG; Department of Ophthalmology, University of California, San Francisco, San Francisco, California. Electronic address: pedig@jaeb.org., Repka MX; Wilmer Eye Institute, Johns Hopkins School of Medicine, Baltimore, Maryland., Hatt SR; Mayo Clinic, Rochester, Minnesota., Sutherland DR; Jaeb Center for Health Research, Tampa, Florida., Leske DA; Mayo Clinic, Rochester, Minnesota., Morrison DG; Vanderbilt University Medical Center, Nashville, Tennessee., Fallaha N; Department of Ophthalmology, Centre Hospitalier Universitaire Sainte-Justine, Montreal, Quebec, Canada., Melia BM; Jaeb Center for Health Research, Tampa, Florida., Kraker RT; Jaeb Center for Health Research, Tampa, Florida., Cotter SA; Southern California College of Optometry at Marshall B. Ketchum University, Fullerton, California., Holmes JM; Department of Ophthalmology and Vision Science, University of Arizona-Tucson, Tucson, Arizona.
Jazyk:	angličtina
Zdroj:	Ophthalmology [Ophthalmology] 2024 Sep 07. Date of Electronic Publication: 2024 Sep 07.
DOI:	10.1016/j.ophtha.2024.08.036
Abstrakt:	Purpose: To report the change in refractive error over 5 years after primary intraocular lens (IOL) placement by age at surgery and to identify factors associated with the change in refractive error after 5 years. Design: Prospective observational study at 61 pediatric eye care practices. Participants: One hundred eighty-six eyes of 152 children undergoing primary IOL implantation before 13 years of age for nontraumatic cataract. Interventions: Cataract surgery with primary IOL placement. Main Outcome Measures: Five-year change in refractive error (spherical equivalent) by age at surgery and by immediate postoperative myopia versus emmetropia or hyperopia. Results: Mean spherical equivalent myopic shift was -5.99 diopters (D; 95% confidence interval [CI], -7.64 to -4.34 D) when surgery was performed at 0 to younger than 1 year of age (n = 13), -3.53 D (-4.57 to -2.48 D) at 1 to younger than 2.5 years of age (n = 28), -1.91 D (-2.55 to -1.26 D) at 2.5 to younger than 4 years of age (n = 36), -2.04 D -2.60 to -1.49 D) at 4 to younger than 7 years of age (n = 60), and -0.83 D (-1.27 to -0.40 D) at 7 to younger than 13 years of age (n = 49; P < 0.01 for each comparison with the oldest group). Variability of myopic shift also decreased with increasing age (P < 0.01). In eyes of children 4 to younger than 13 years of age (small sample size precluded analysis of children younger than 4 years), significantly less mean change in refractive error was found over 5 years in eyes with myopia immediately after surgery (-0.69 D; 95% CI, -1.48 to 0.10 D; n = 27) than eyes with emmetropia or hyperopia immediately after surgery (-1.70 D; 95% CI, -2.10 to -1.31 D, n = 82; difference, -1.01 D [95% CI, -1.89 to -0.14 D]; P = 0.03). Conclusions: In this large, prospective cohort study of children younger than 13 years undergoing cataract surgery with primary IOL placement, greater and more variable myopic shift was found in children undergoing surgery at a younger age. Our finding of less myopic shift over 5 years in eyes with unintended immediate postoperative myopia deserves further study to guide IOL power selection more accurately. Financial Disclosure(s): Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article. (Copyright © 2024 American Academy of Ophthalmology. Published by Elsevier Inc. All rights reserved.)
Databáze:	MEDLINE
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