Rupal H Trivedi1, Eliza Barnwell2, Bethany Wolf2, M Edward Wilson2. 1. Storm Eye Institute, Medical University of South Carolina, Charleston, South Carolina, USA. Electronic address: trivedi@musc.edu. 2. Storm Eye Institute, Medical University of South Carolina, Charleston, South Carolina, USA.
Abstract
PURPOSE: To develop a model for predicting postoperative globe axial length (AL) in children undergoing bilateral cataract surgery with primary intraocular lens (IOL) implantation in children older than 2 years. DESIGN: Retrospective case series. METHODS: Children were included only if AL data were available for both eyes before surgery and at least 1 year after surgery. We analyzed variables that could influence globe axial growth and developed a multivariable generalized estimating equation regression model to predict postoperative AL. RESULTS: Sixty-four children were included. The median age at surgery and at follow-up was 5.1 and 12.5 years, respectively. AL measurements were obtained in both eyes during 242 visits. The median AL before and at last follow-up was 22.2 and 23.1 mm, respectively. Beta value for the final model to predict postoperative AL is as below: intercept (1.93), preoperative AL (0.91), age at cataract surgery (-0.07), age at follow-up (0.14), and interaction between age at surgery and age at follow-up (-0.005). Using this model, for a hypothetical patient operated at 2.5 years of age with a 20.5 mm AL would be estimated to have a 22.8 mm AL at 18 years of age. CONCLUSION: IOL power selection is a major challenge of pediatric cataract surgery attributable to unpredictable future eye growth. This model theoretically could be used to predict individual future adult size AL for each child undergoing cataract surgery, helping the surgeon to customize the selection of an IOL power at implantation and also to help the parents understand what to expect.
PURPOSE: To develop a model for predicting postoperative globe axial length (AL) in children undergoing bilateral cataract surgery with primary intraocular lens (IOL) implantation in children older than 2 years. DESIGN: Retrospective case series. METHODS:Children were included only if AL data were available for both eyes before surgery and at least 1 year after surgery. We analyzed variables that could influence globe axial growth and developed a multivariable generalized estimating equation regression model to predict postoperative AL. RESULTS: Sixty-four children were included. The median age at surgery and at follow-up was 5.1 and 12.5 years, respectively. AL measurements were obtained in both eyes during 242 visits. The median AL before and at last follow-up was 22.2 and 23.1 mm, respectively. Beta value for the final model to predict postoperative AL is as below: intercept (1.93), preoperative AL (0.91), age at cataract surgery (-0.07), age at follow-up (0.14), and interaction between age at surgery and age at follow-up (-0.005). Using this model, for a hypothetical patient operated at 2.5 years of age with a 20.5 mm AL would be estimated to have a 22.8 mm AL at 18 years of age. CONCLUSION: IOL power selection is a major challenge of pediatric cataract surgery attributable to unpredictable future eye growth. This model theoretically could be used to predict individual future adult size AL for each child undergoing cataract surgery, helping the surgeon to customize the selection of an IOL power at implantation and also to help the parents understand what to expect.
Authors: Ingrid Kielhorn; Madhavan S Rajan; Peter M Tesha; Visva Raja Subryan; John A Bell Journal: J Cataract Refract Surg Date: 2003-03 Impact factor: 3.351
Authors: Paul A Harris; Robert Taylor; Robert Thielke; Jonathon Payne; Nathaniel Gonzalez; Jose G Conde Journal: J Biomed Inform Date: 2008-09-30 Impact factor: 6.317
Authors: David A Plager; Hal Kipfer; Derek T Sprunger; Naval Sondhi; Daniel E Neely Journal: J Cataract Refract Surg Date: 2002-05 Impact factor: 3.351