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    Weighing pros, cons of IOL implantation in pediatric cataract

    Study with children under age of 2 finds equal rate of glaucoma but more posterior synechiae

    Take-home message: IOL implantation was associated with more inflammation and slightly more visual obscuration in 120 children age 2 or younger undergoing bilateral cataract surgery. However, the rate of glaucoma was similar compared with an aphakic group. 

    Ahmedabad, India—IOL implantation in children under the age of 2 does not always lead to a higher rate of glaucoma, but posterior synechiae can be more common, said Abhay Vasavada, MS, FRCS.

    Pediatric cataract surgeons most frequently consider the safety associated with various treatments for pediatric cataract, said Dr. Vasavada, director, Iladevi Cataract and IOL Research Centre, Ahmedabad, India.

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    Some studies, such as the Infant Aphakia Treatment Study, have examined this topic. Though investigators have focused on unilateral cataract, there is still a need to analyze safety and outcomes in bilateral cataract.

    Aphakic glasses can work well, but patients and their families are seeking alternatives.

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    “There’s nothing wrong with glasses, but now that lifestyles are changing, those glasses are becoming a handicap,” he said.

    On the surface, it may seem that contact lenses would be another treatment option. However—contact lenses in many parts of the world are expensive and actually impractical—they need a lot of support, Dr. Vasavada said.

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    For these reasons, more surgeons in centers outside of the United States are considering IOL implantation. There has been some hesitation because of concern about the development of glaucoma.

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