Factors associated with progressive anisometropia after bilateral intraocular lens implantation in patients with pediatric cataract

• Published in: Eye (London) 2024-02, Vol.38 (3), p.594-599
• Main Authors: liu, Enze, Lin, Lei, Zhang, Mengdi, Liu, Jiasheng, Zhu, Mengchao, Zhu, Kaiyi, Mo, Er, Xu, Jialin, Zhao, Yun-e, Li, Jin
• Format: Article
• Language: English
• Subjects: 692/499; 692/699; 692/699/3161/3168; Anisometropia - etiology; Cataract - complications; Cataract Extraction - adverse effects; Cataracts; Child; Child, Preschool; Follow-Up Studies; Humans; Infant; Intraocular lenses; Laboratory Medicine; Lens Implantation, Intraocular; Lenses, Intraocular; Medicine; Medicine & Public Health; Ophthalmology; Patients; Pediatrics; Pharmaceutical Sciences/Technology; Regression analysis; Strabismus; Surgery; Surgical Oncology; Visual Acuity
• ISSN: 0950-222X; 1476-5454
• DOI: 10.1038/s41433-023-02740-4

Objectives To identify factors associated with progressive anisometropia after bilateral intraocular lens (IOL) implantation in patients with pediatric cataract. Methods Clinical and standardized questionnaire data were collected for Sixty-eight patients with pediatric cataract (136 eyes) who underwent bilateral IOL implantation and at least 1 year of follow-up. Univariate and multivariate linear regression models were used to identify factors associated with postoperative anisometropia. Results The median age at IOL implantation was 3.2 years (range: 1–12.4 years), and median follow-up time was 5.7 years (range: 1.1–14 years). At 1 month postoperatively and at the last follow-up, there were 19 (27%) and 31 (46%) cases of anisometropia ≥1 D, 9 (13%) and 15 (22%) cases of anisometropia ≥2 D, and 2 (3%) and 9 (13%) cases of anisometropia ≥3 D, respectively. Compared with 1 month postoperatively, the amount of anisometropia increased in 45 (67%) patients. Greater anisometropia one year or more after bilateral IOL implantation was associated with larger intereye difference in IOL power ( P  = 0.032, 95%CI 0.013 to 0.285), intereye difference in preoperative axial length ( P  = 0.018, 95%CI –1.247 to –0.123), presence of strabismus ( P  = 0.017, 95%CI 0.063–0.601), anisometropia at 1 month postoperatively ( P  = 0.001, 95%CI 0.126–0.478), and intereye difference in axial length at the last follow-up ( P  = 0.047, 95%CI 0.005–0.627). Conclusion Anisometropia might progress after bilateral IOL implantation in patients with pediatric cataract. Greater intereye difference in IOL power, presence of strabismus might increase the potential of progressive anisometropia.