Our experience in ocular biometry in congenital and infantile cataract

Purpose: To establish the importance of ocular biometry in congenital and infantile cataract upon the visual outcomes. Methods: The study was a retrospective study upon patients with congenital and infantile cataract. The study group included 58 eyes from 36 children. For cooperative children, for the ocular biometry we used the OCUSCAN biometer (Alcon, Forth Worth Tx). In very young children we used B-scan ultrasonography to measure the axial length (AXL) of the eye. The target refraction was hyperopia, concording with the age. Results: The measurement of axial length revealed an eye between 20 and above 25 mm. The correlation between axial length and age showed a rapid increase in the first 12 months, a smaller increase between 100-150 months and stabilization after 200 months (statistically significant-medium correlation). The correlation between keratometry and age showed higher values of keratometry at younger children, with a significant decrease in the first 12 months and a smaller rate of decrease after 24 months of age (statistically significant-high correlation). Conclusion: our study shows that the axial length increases during childhood, especially in the first 2 years and the corneal curvature decreases from birth to different ages, parameters which induce the target refraction. Introduction Congenital cataract is defined as the lens opacification which appears at birth or in the first months of life [1]. Infantile cataract represents the opacification of the lens which appears after 2 years of age. Congenital and infantile cataracts produce deprivation amblyopia and can thus cause long life visual impairment [2]. Visual deprivation has a significant impact on the development of fixation stability. That’s why it’s necessary an early diagnosis and referral for surgery in order to assure an accurate optical rehabilitation. Appropriate refractive outcome following pediatric cataract surgery with intraocular lens implantation (IOL) requires accurate biometry [3], which should be carried-out by personnel experienced in biometry in infants and children. The calculation of IOL power in infants below 1 years of age is prone to error [4]. Main reasons for sub-optical errors were: technical difficulties in measuring biometric parameters, the use of formulas and incomplete knowledge of the development of the eye in the first years of life. That’s why managing cataracts in children remains a challenge. The timing of the surgical treatment is crucial for the visual development and successful rehabilitation of children. Material and method The study was a retrospective study upon patients with congenital and infantile cataract for a period of 3 years (2009-2012). The study group included 36 children, and a number of 58 eyes. In our study were included children of both gender with congenital or infantile cataract, aged between 2 months and 13 years, with primary implantation of intraocular lenses (IOL). From the study were excluded the cases of traumatic or complicated cataract, microcornea, Correspondence to: Dr. Cristina Nicula, MD; PhD, Associate Professor, ClujNapoca University Ophthalmology Clinic, Cluj County Hospital No. 3-5, Clinicilor Street, 400006, Cluj-Napoca, Romania, Tel: +40 722 849 575; E-mail: [email protected]