Long-term results of pediatric cataract surgery and primary intraocular lens implantation from 7 to 22 months of life.

IMPORTANCE Pediatric primary posterior intraocular lens (IOL) implantation in children older than 24 months has become the standard of care. Results of the Infantile Aphakia Treatment Study have concluded that primary IOL implantation before age 7 months has no advantages over aphakia. The current evidence does not address our understanding of the risks and benefits of primary IOL implantation for children aged 7 to 24 months. OBSERVATIONS Final optotype acuity, adverse events, refractive growth, strabismus, binocular function, and need for additional surgery were retrospectively reviewed for 14 eyes of 10 patients from November 2001 to June 2012. The records were reviewed for children aged 6 to 24 months; included patients were aged 7 to 22 months. The mean (SD) visual acuity was 0.29 (0.30) logMAR (Snellen equivalent 20/40). The mean follow-up was 5 years. The rate of adverse events was 3 in 14 eyes (21%). Adverse events included lens reproliferation (2 eyes) and lens dislocation (1 eye). The rate of strabismus correction was 4 in 10 patients (40%). The mean (SD) rate of refractive growth at 3 times the age at surgery was -5.80 (3.09) diopters. CONCLUSIONS AND RELEVANCE The data suggest that primary IOL implantation in this age group has a lower rate of adverse events than reported in the Infantile Aphakia Treatment Study. Additionally, favorable visual outcome was found, similar to that in children undergoing primary IOL implantation when older than 2 years. Primary IOL implantation should be considered in children who require cataract surgery after age 7 months.