Frequency of myopia development after congenital cataract extraction in infancy with different keratometric and biometric parameters in pseudophakic eyes

Abstract

Aim. In most children, unplanned myopia develops after the extraction of congenital cataracts (CC) with t he implantation of intraocular lenses (IOLs) in infancy; thus, it is necessary to analyze the mechanisms of its development.

The study aimed to investigate the role of keratometric and biometric indicators of eyes in pediatric patients with pseudophakia in the formation of myopia.

Material and methods. Analysis of refraction indices, degree of postoperative astigmatism, and length of the anteroposterior axis (APO) was performed in 40 pediatric patients (56 eyes) with bilateral (29 children, 45 eyes) and unilateral (11 children) pseudophakia at the age of 4 to 8 years after CC extraction with IOL implantation in infancy.

Results. Myopia was detected in 67.9% (38 eyes, 28 children) of cases, including 41.1% (23 eyes, 16 children) with moderate (12 eyes) and high (11 eyes) myopia. The study revealed a direct average correlation between the magnitude of astigmatism and the degree of developing myopia. Astigmatism of >3.25 diopters was detected frequently in moderate and high myopia. For eyes with astigmatism of >3.25 diopters, the APO length was 22.6 ± 1.9 mm (21.8–23.5 mm), whereas for those with astigmatism of <3.0 diopters, it was 20.9 ± 1.8 mm (20.3–21.5 mm). With the initial APO length of <20.0 mm, less eye growth was registered in the postoperative period.

Conclusion. In the majority of pediatric patients with pseudophakia, myopic refraction develops after CC extraction in infancy, which is influenced by the degree of astigmatism and the initial values of the APO length. Astigmatism of >3.0 diopters causes irregular peripheral defocus on the retina, which contributes to the overgrowth of the eye with pseudophakia after early CC extraction, leading to axial myopia. In CC eyes, the risk of myopia is lower with an initial APO length of <20.0 mm.

Keywords

congenital cataract / pseudophakia / myopia / astigmatism

References

[1] Zaidullin IS. Sistema khirurgicheskikh vmeshatel’stv pri patologii khrustalika v oslozhnennykh sluchayakh u detei [dissertation abstract]. Krasnoyarsk; 2012. 46 p. Available from: http://www.buzaev.ru/downloads/disser.pdf. (In Russ.).

[2] Зайдуллин И.С. Система хирургических вмешательств при патологии хрусталика в осложненных случаях у детей: автореф. дис. … д-ра мед. наук. Красноярск, 2012. 46 с. Режим доступа: http://medical-diss.com/docreader/354618/a?#?page=1. Дата обращения: 12.12.2020.

[3] Kruglova TB, Kononov LB. Peculiarities of intraocular lens power calculation in infants under 1 year of age with congenital cataract. Vestnik oftal’mologii. 2013;129(4):66-69. (In Russ.)

[4] Круглова Т.Б., Кононов Л.Б. Особенности расчета оптической силы интраокулярной линзы, имплантируемой детям первого года жизни с врожденными катарактами // Вестник офтальмологии. 2013. Т. 129. № 4. С. 66-69.

[5] Dahan E, Drusedau MU. Choice of lens and dioptric power in pediatric pseudophakia. J Cataract Refract Surg. 1997;23 Suppl 1:618-623. Doi: 10.1016/S0886-3350(97)80043-0.

[6] Dahan E., Drusedau M.U. Choice of lens and dioptric power in pediatric pseudophakia // J Cataract Refract Surg. 1997. Vol. 23. Suppl 1. P. 618-623. Doi: 10.1016/S0886-3350(97)80043-0.

[7] Katargina LA, Kruglova TB, Egiyan NS, Trifonova OB. The dynamics of the length of the anterior-posterior eye axis following the extraction of unilateral congenital cataracts with the implantation of intraocular lenses in the children during the first year of life. Russian Pediatric Ophthalmology. 2017;(1):6-10. (In Russ.). Doi: 10.18821/1993-1859-2017-12-1-6-10.

[8] Катаргина Л.А., Круглова Т.Б., Егиян Н.С., Трифонова О.Б. Динамика длины передне-задней оси глаз после экстракции односторонних врожденных катаракт с имплантацией интраокулярных линз на первом году жизни детей // Российская педиатрическая офтальмология. 2017. №1. С. 6-10. Doi: 10.18821/1993-1859-2017-12-1-6-10.

[9] Ishberdina LSh, Bikbov MM. Results of congenital cataract surgery and aphakia correction in young children. Oftal’mokhirurgiya. 2010;(6):13-17. (In Russ.)

[10] Ишбердина Л.Ш., Бикбов М.М. Результаты хирургии врожденной катаракты и коррекции афакии у детей раннего возраста // Офтальмохирургия. 2010. № 6. С. 13-17.

[11] Fan DS, Rao SK, Cheung EY, et al. Astigmatism in Chinese preschool children: prevalence, change, and effect on refractive development. Br J Ophthalmol. 2004;88(7):938-941. Doi: 10.1136/bjo.2003.030338.

[12] Fan D.S., Rao S.K., Cheung E.Y. et al. Astigmatism in Chinese preschool children: prevalence, change, and effect on refractive development // Br J Ophthalmol. 2004. Vol. 88. N 7. P. 938-941. Doi: 10.1136/bjo.2003.030338.

[13] Twelker JD, Miller JM, Sherrill DL, Harvey EM. Astigmatism and myopia in Tohono O’odham Native American children. Optom Vis Sci. 2013;90(11):1267-1273. Doi: 10.1097/OPX.0000000000000065.

[14] Twelker J.D., Miller J.M., Sherrill D.L., Harvey E.M. Astigmatism and myopia in Tohono O’odham Native American children // Optom Vis Sci. 2013. Vol. 90. N 11. P. 1267-1273. Doi: 10.1097/OPX.0000000000000065.

[15] Yusupov AA, Boboev SA, Khamrakulov SB, et al. Interrelation of functional and anatomical-optical parameters of the eye in congenital myopia. Voprosy nauki i obrazovaniya. 2020;(22):44-53. (In Russ.)

[16] Юсупов А.А., Бобоев С.А., Хамракулов С.Б. и др. Взаимосвязь функциональных и анатомо-оптических параметров глаза при врожденной близорукости // Вопросы науки и образования. 2020. № 22. С. 44-53.

[17] Lin H, Lin D, Liu Z, et al. A novel congenital cataract category system based on lens opacity locations and relevant anterior segment characteristics. Invest Ophthalmol Vis Sci. 2016;57(14):6389-6395. Doi: 10.1167/iovs.16-20280.

[18] Lin H., Lin D., Liu Z. et al. A novel congenital cataract category system based on lens opacity locations and relevant anterior segment characteristics // Invest Ophthalmol Vis Sci. 2016. Vol. 57. N 14. P. 6389-6395. Doi: 10.1167/iovs.16-20280.

[19] Seven E, Tekin S, Batur M, et al. Evaluation of changes in axial length after congenital cataract surgery. J Cataract Refract Surg. 2019;45(4):470-474. Doi: 10.1016/j.jcrs.2018.11.012.

[20] Seven E., Tekin S., Batur M. et al. Evaluation of changes in axial length after congenital cataract surgery // J Cataract Refract Surg. 2019. Vol. 45. N 4. P. 470-474. Doi: 10.1016/j.jcrs.2018.11.012.

[21] Trivedi RH, Wilson ME Jr. Changes in interocular axial length after pediatric cataract surgery. J AAPOS. 2007;11(3):225-229. Doi: 10.1016/j.jaapos.2006.09.015.

[22] Trivedi R.H., Wilson M.E. Jr. Changes in interocular axial length after pediatric cataract surgery // J AAPOS. 2007. Vol. 11. N 3. P. 225-229. Doi: 10.1016/j.jaapos.2006.09.015.

[23] Ashworth JL, Maino AP, Biswas S, Lloyd IC. Refractive outcomes after primary intraocular lens implantation in infants. Br J Ophthalmol. 2007;91(5):596-599. Doi: 10.1136/bjo.2006.108571.

[24] Ashworth J.L., Maino A.P., Biswas S., Lloyd I.C. Refractive outcomes after primary intraocular lens implantation in infants // Br J Ophthalmol. 2007. Vol. 91. N 5. P. 596-599. Doi: 10.1136/bjo.2006.108571.

[25] Shih YF, Ho TC, Chen MS, et al. Experimental myopia in chickens induced by corneal astigmatism. Acta Ophthalmol (Copenh). 1994;72(5):597-601. Doi: 10.1111/j.1755-3768.1994.tb07185.x.

[26] Shih Y.F., Ho T.C., Chen M.S. et al. Experimental myopia in chickens induced by corneal astigmatism // Acta Ophthalmol (Copenh). 1994. Vol. 72. N 5. P. 597-601. Doi: 10.1111/j.1755-3768.1994.tb07185.x.

RIGHTS & PERMISSIONS

Eco-Vector