Visual outcomes and safety profile of intraocular lens implantation versus aphakia in children with microspherophakia with no subluxation

ObjectiveTo study the visual, refractive and surgical outcomes of intraocular lens (IOL) implantation versus aphakia in children with microspherophakia.DesignRetrospective, comparative, non-randomised interventional study.MethodsAll consecutive children with microspherophakia who satisfied the inclusion criteria were included. The eyes that underwent in-the-bag IOL implantation and those that were left aphakic were included in groups A and B, respectively. The postoperative visual outcomes, IOL stability and complications during the follow-up period were studied.Results22 eyes (13 patients, male 76%), of which 12 eyes were in group A and 10 eyes in group B. The mean +/- SE of age at surgery was 9.4 +/- 1.4 and 7.3 +/- 0.9 years in group A and group B, respectively (p value 0.18). The mean follow-up of group A was 0.9 +/- 0.4 years (median 0.5 years; Q1 0.04, Q3 2.16) and group B was 1.3 +/- 0.9 years (median 0.147 years; Q1 0.08, Q3 0.39) (p value 0.76). All the baseline biometric variables including best-corrected visual acuity (BCVA) were comparable in each group. The final BCVA in logMAR adjusted for follow-up was comparable in both group A (0.29 +/- 0.06) and group B (0.52 +/- 0.09) (p value 0.06). Mean predictive error of IOL power in microspherophakia was 0.17 +/- 0.43.The most common complication in group A was visual axis opacification of two eyes (16.7%, 95% CI 2.9% to 49.1%), of which one eye (8.3%, 95% CI 0.4% to 40.2%) needed membranectomy. Vitreous in anterior chamber was the most common complication in group B, seen in two eyes (20%, 95% CI 3.5% to 55.8%), of which one eye (10%, 95% CI 0.5% to 45.9%) underwent YAG laser vitreolysis. The survival analysis (p value 0.18) was comparable in each group.ConclusionIn-the-bag IOL is an option, which can be considered in selected cases of microspherophakia in developing nations where regular follow-up and economic constraints are a major concern.