Abstract
Primary intraocular lens (IOL) implantation can be done at any age, including early infancy. However, in the first 6 months of age, the preferred approach is to leave the child aphakic and implant an IOL at a later date when the child is older and the remaining refractive growth is easier to predict. There is a higher incidence of reoperations for visual axis opacification when IOLs are implanted in the first 6 months of life compared to leaving the child aphakic. These results have resulted in more children being left aphakic when operated in infancy. Most of these children will eventually undergo secondary IOL implantation. For the initial aphakia after infantile cataract surgery, timely refractive correction is necessary to preserve monocular vision and binocularity and to protect against stimulus deprivational amblyopia. Conservative management may include correction with glasses or contact lenses, although these measures are not possible for all children. Aphakic spectacles are an option for bilateral aphakic children but often undesirable for social and optical reasons. Secondary implantation of an IOL is generally recommended when traditional spectacle or contact lens correction of aphakia is unsuccessful or becomes a barrier to the child’s development and activities of daily living.
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Wilson, M.E., Trivedi, R.H. (2022). Secondary IOL in Congenital Cataract Surgery. In: Khokhar, S.K., Dhull, C. (eds) Essentials of Pediatric Cataract Surgery. Springer, Singapore. https://doi.org/10.1007/978-981-16-0212-2_5
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DOI: https://doi.org/10.1007/978-981-16-0212-2_5
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