A comparative analysis of myopia development in children with bilateral and unilateral pseudophakia

After the extraction of congenital cataract in infancy, postoperative refraction changes differently in patients with bilateral and unilateral pseudophakia. Purpose: to compare myopia development in children with bilateral and unilateral pseudophakia. Material and methods. We examined 33 children (63 eyes) with bilateral and 21 children with unilateral pseudophakia for long-term results of congenital cataract extraction performed in their infancy, The evaluated parameters included the incidence and degree of myopia, refraction, general postsurgical astigmatism, and axial length of the eye. Refraction was measured by Nidek ARK-530A (Japan). The axial length was measured by ultrasound B-scan (Voluson E8, GE) or by optical biometry (AL-Scan, Nidek). Results. In bilateral pseudophakia, high myopia was detected if astigmatism was more than 3.25 D or oblique. In the latter case, the eyeball showed a greater growth as compared to with-the-rule astigmatism (4.67 mm and 3.26 mm, respectively; p < 0.05). With incomplete correction of astigmatism in the case of bilateral pseudophakia, myopia progressed to a high degree in nearly half of the cases (48.1 %), and a greater growth of the eye was detected compared with complete correction (4.45 mm and 3.42 mm respectively; p > 0.05). The type and degree of astigmatism did not affect the development and progression of myopia in unilateral pseudophakia. Conclusion. The effect of undercorrected astigmatic defocus on the development and progression of myopia in bilateral pseudophakia is apparently associated with a equivalent visual load on both eyes, while this load is significantly reduced in unilateral pseudophakia so that it fails to affect the development of myopia in such cases.

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