Refractive outcomes and prediction error following secondary intraocular lens implantation in children: a decade-long analysis

Aim To evaluate the refractive outcomes, prediction error (PE) and factors affecting PE in children with aphakia following congenital cataract surgery undergoing secondary intraocular lens (IOL) implantation. Methods We analysed the records of children less than 16years old who underwent secondary IOL implantation for aphakia following congenital cataract surgery. PE and absolute PE for each case calculated 3months following secondary IOL implantation were analysed. Multiple regression analysis was performed to determine the relationship between age at secondary IOL implantation, axial length, keratometry readings and PE. Results 174 eyes of 104 children were analysed. Mean age at surgery was 6.083.75 years. The mean PE was 1.65 +/- 2.46 dioptres (D) (range -3.25 to 7.5 D) and mean absolute PE was 2.15 +/- 1.68 D (range 0-7.5 D) at 3months. There was a statistically significant difference in absolute PE between eyes in which IOL calculation was performed using IOL master (1.80 +/- 1.40 D) versus IOL calculation under general anaesthesia with contact method (2.43 +/- 1.83 D), p=0.01. Multiple regression analysis revealed an inverse relationship between age at secondary IOL implantation and mean absolute PE (p=0.01). Conclusions IOL power calculation with SRK II formula with sulcus placement of IOL gives favourable refractive outcomes. Though age-based refraction is targeted, a significant PE may be expected.