Comparison of Three Types of Intraocular Lens in Pediatric Cataract Surgery

To compare the results of three-piece and one- piece hydrophobic acrylic posterior chamber intraocular lens (IOL) with poly methyl metacrylate (PMMA) IOL implanted during lensectomy, posterior capsulotomy and anterior vitrectomy for congenital or developmental cataract. This is a historical cohort study conducted on patients with congenital or developmental cataract who underwent lensectomy, posterior capsulotomy and anterior vitrectomy between 1992 and 2012. Main outcomes were best-corrected visual acuity, early and final astigmatism, and postoperative complications including uveitis and visual axis opacification. A total of 67 eyes of 39 patients were included in the study. PMMA, three-piece (Alcon MA60 - AC) and one-piece (Alcon SA60 – AT) IOLs were implanted in 27, 22 and 18 eyes, respectively. The mean followup period was 101±49, 74±55 and 38±42 months, respectively. Best-corrected visual acuity was not significantly different among groups (P=0.823). Although early postoperative astigmatism was higher in the PMMA group, there was no significant difference among the study groups in the long term follow-up. The rate of postoperative uveitis, visual axis opacification and a need for laser capsulotomy was comparable in all groups. Although in-the-bag foldable acrylic IOL implantation is preferred during lensectomy, posterior capsulotomy, and anterior vitrectomy for congenital or developmental cataract, PMMA posterior chamber intraocular lenses can still be a safe and acceptable alternative, especially when sulcus fixation of the intraocular lens is scheduled.