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Refraction study on pseudophakic children

PURPOSE: To verify the refractive alterations in eyes of children submitted to surgery with implant of intraocular lens (IOL) and to investigate prediction of biometry in these cases. METHODS: Thirty-three eyes were studied with previous measurement of visual acuity with indication for cataract surgery with implant of intraocular lens in the Outpatient Clinic of Congenital Cataract of the Federal of University of São Paulo/Paulista School of Medicine, (UNIFESP-EPM) from January, 1998 to December, 2000. After the surgery, refraction, prescription of glasses with appropriate treatment for visual stimulation of the children, and measurement of the final corrected visual acuity were performed. Final refraction, biometric accuracy and possible error factors were analyzed. RESULTS: Thirty-three surgeries in 29 children were performed. Mean follow-up time was 10.15 months ranging from 2 to 34±8.18 months. In 43% of the cases a vision equal to or grater than 20/50 was obtained. Forty-six percent of the patients presented a final refraction between +1.00 and -1.00 spherical diopters. CONCLUSION: Treatment of congenital cataract through implant of intraocular lens continues to be controversial, where long-term results are not known. A great number of patients were operated on at a late time and progressed with amblyopia and low visual acuity even after treatment with difficult access to early and adequate treatment. In spite of residual refraction the patients obtained good visual acuity. Twenty-one percent of the cases with refractive alteration with hyperopia will still have increase in their axial diameter and consequently myopia with reduction of their refraction.

Cataract; Cataract extraction; Lens, implantation; intraocular lens; Visual acuity; Refraction, ocular refraction; Biometry; Child


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