Intraocular lens implantation in children with unilateral congenital cataract in the first 4 years of life

To describe the outcome of phacoaspiration with intraocular lens implantation in children with unilateral congenital cataract in the first 4？years of life. A retrospective chart review of children with visually significant unilateral congenital cataract presenting in the first 4？years of life was done. Children with a minimum postsurgical follow-up of 1？year were included. Outcome measures were mean spherical equivalent, visual axis clarity, visual acuity and complications till the last follow-up. Ninety-three children met the inclusion criteria. The mean age of surgery was 13.23？±？11.89？months and the mean follow-up period was 24.37？±？17.35？months. Nearly 40% of children presented during their first year of life. No difference was noted between the subgroups in terms of age (p？=？0.310), sex (p？=？0.475) or laterality (p？=？0.349). Surgical membranectomy was performed in 22 eyes (23.6%) after an average period of 4.85？±？2.58？months after surgery. One eye underwent piggy back intraocular lens and four eyes underwent intraocular lens exchange after a mean duration of 50？months (range 40–60？months). The mean visual acuity was 0.79？±？0.11 (log MAR chart). A total of 60.7% of these children (n？=？31) achieved best corrected visual acuity or 20/80 or better. The results of our study suggest that primary intraocular lens implantation in children with unilateral congenital cataract gives good structural and functional results. Besides a meticulous surgery, visual outcome is affected by the time of presentation and postoperative compliance to amblyopia therapy