Age and laterality of children should be considered when determining IOL power

A study featured in the British Journal of Ophthalmology has shown that a child's age and laterality are important factors to consider when determining intraocular lens (IOL) power.

A team lead by Dr R. Wolfs, Erasmus University Medical Center, Department of Ophthalmology, The Netherlands, investigated the amount of myopic shift in children after catract surgery with IOL implantation. The children were split into three groups according to their age. Group A consisted of 0–1 year olds, Group B, 1–7 year olds and Group C, 7–18 year olds. Expected myopic shift was calculated using a formula created by multiple regression analysis. Variables linked with a higher prediction area were also calculated.

Children aged 12 months and under presented with higher myopic shifts and a bigger mean rate of refractive change per year. Higher myopic shifts were also found in children with unilateral cataract. Group A experienced a significantly higher absolute prediction error compared to Group B and Group C.

The results demonstrate that predicting the postoperative refraction in children under 1 years old is complex and factors such as age and laterality need to be considered.