Clinical Study Of Postoperative Refraction After Cataract Extraction And Intraocular Lens Implantation In Cataract Children

Purpose:To compare the postoperative refraction with the target refraction of the children who underwent cataract extraction and intraocular lens(IOL)implantation,and to investigate the source of prediction error.Methods:Prospective study.64 eyes of 42 cataract children were enrolled in this study from September 2017 to November 2019 in Shengjing Hospital,China Medical University.There were 49 eyes of 33 children who received cataract extraction combined with anterior vitrectomy and in-the-bag IOL implantation in group A,and were divided into 3 groups as follow: age≤3 years,3 years<age≤6 years,age>6 years.15 eyes of 9 children received secondary sulcus IOL implantation were group B.The axial length(AL),corneal diameter(CD)and anterior chamber depth(ACD)were measured preoperatively.We predicted the postoperative refraction by using the SRK/T formulas and measured 3 months postoperative mean error(ME)and mean absolute error(MAE).One-way analysis of variance,t test,Mann-Whitney U test and Spearman correlation were used to compare the ME,MAE,AL and age.Result:For group A,the AL was(22.51±1.43)D preoperatively,the age was(5.16±2.79)years preoperatively.For group B,the AL was(22.19±1.76)D preoperatively,the age was(2.97±0.86)years preoperatively.3 months after surgery,the proportion of MAE less than 1.00 D was 46.93%,less than 2.00 D was 73.47%,less than 3.00 D was 85.71%,and MAE more than 3.00 D was 14.28% for group A.The proportion of MAE less than 1.00 D was 20.00%,less than 2.00 D was 53.33%,less than 3.00 D was 66.67%,and MAE more than 3.00 D was 33.33% for group B 3 months postoperatively.There was no statistical significance in MAE and ME among each subgroup in group A(P>0.05).The results shew ME of group A(year≤3)was significantly higher than group B(t=2.53,P=0.02),MAE was significantly lower than group B(t=-2.11,P=0.04).In group B,AL had positive correlation with ME(P=0.01),and negative correlation with MAE(P=0.01).Conclusion:(1)Majority of the children who received in-the-bag IOL implantation or secondary sulcus IOL implantation achieved ideal postoperative refraction,and the operation was safe and effective.(2)As for the same age,children underwent first stage in-the-bag IOL implantation,the refractive outcomes shown lower refraction error and lower myopia tendency when compared with children underwent secondary ciliary sulcus IOL implantation.(3)For children underwent secondary sulcus IOL implantation,the refraction error had correlation with AL,the longer the AL was,the smaller the refraction error was.