Challenges and Consequences of IOL-Implantation in Children with Congenital Cataract before the Age of One Year

Aim To evaluate the intra-operative challenges and post- operative consequences of IOL implantation in children before the age of one year.  Methods 40 eyes of 20 patients with congenital cataract underwent cataract surgeries under general anesthesia were included in this study. Mean age was 9±1 months (7 months to 1 year). All the cases were reviewed at 1 week, 1 month, 3 months and 6 months intervals. The cases completed at least 6 months follow up were included in this study. Intra-operative difficulties, post-operative complications and final visual outcome were recorded.  Results Small eyeball, anterior capsular calcification, thick posterior capsular plaque and pre-existing posterior capsular dehiscence are the major intra-operative challenges. Treatment incompliance, secondary membrane formation, increase intraocular pressure and it’s measurement, changes in refraction and amblyopia are the important concern of IOL implantation in children before the age of one year.  Conclusion Stimulus deprivation amblyopia is the main cause of decreased vision after IOL implantation in children before 1 year of age. Primary IOL implantation after 7 months is safe method to avoid amblyopia and obtain visual rehabilitation in small children.