Effect of age at time of cataract surgery on subsequent axial length growth in infant eyes

Abstract

To determine whether removal of the crystalline lens and placement of an intraocular lens (IOL) in human infant eyes retard the growth of the pseudophakic eye. A unilateral lensectomy with placement of a posterior chamber IOL in the sulcus was performed in 11 infants between 2 and 4 months of age. Axial length measurements of both eyes were obtained preoperatively and postoperatively. Patients were followed for a mean of 5.6 years. In 7 patients, the mean axial growth was 0.46 mm less in the pseudophakic eye than in the fellow eye (range 0.15 to 0.70 mm). In 1 patient, there was no interocular axial length difference and in 3, the pseudophakic eye was longer. When measurements from the only patient with microphthalmia were excluded, the interocular difference in axial growth was highly significant (signed rank test, P = .006). Median visual acuity of the pseudophakic eyes at the last follow-up was 20/60 (range 20/30 to 20/200). The final visual acuity in the pseudophakic eyes did not correlate with the degree of interocular axial length difference (P > .05). Our study suggests there may be a reduction in axial growth in infantile eyes following cataract extraction and IOL implantation. This effect probably reduces the magnitude of the myopic shift in these eyes.