Aim-To assess changes in axial length, corneal curvature, and refraction in paediatric pseudophakia. Methods-35 eyes of 24 patients with congenital or developmental lens opacities underwent extracapsular cataract extraction and posterior chamber intraocular lens implantation. Serial measurements were made of axial length, corneal curvature, objective refraction, and visual acuity. Results-For patients with congenital cataracts (onset <1 year age) the mean age at surgery was 24 weeks. Over the mean follow up period of 2.7 years, the mean increase in axial length of 3.41 mm was not significantly diVerent from the value of an expected mean growth of 3.44 mm (paired t test, p=0.97) after correction for gestational age. In the developmental cataract group (onset >1 year of age) the mean age at surgery was 6. Conclusion-The pattern of axial elongation and corneal flattening was similar in the congenital and developmental groups to that observed in normal eyes. No significant retardation or acceleration of axial growth was found in the eyes implanted with IOLs compared with normal eyes. A myopic shift was seen particularly in eyes operated on at 4-8 weeks of age and it is recommended that these eyes are made 6 D hypermetropic initially with the residual refractive error being corrected with spectacles. (Br J Ophthalmol 1999;83:265-269) Among the problems which arise regarding the use of intraocular lenses (IOLs) in the paediatric population is the question of the power of the implant that should be used, considering the expected growth of the child's eye. The majority of eye growth takes place in the first 18 months of life after which there is little change.
With careful management and patient selection, the use of IOLs in children can produce good visual results with a minimum of complications. Further follow-up is needed to assess the long-term visual outcome, complications, and changes in refraction.
Eight children with the fetal alcohol syndrome are described with ocular anomalies. They all had a strong history of maternal alcohol abuse throughout pregnancy, especially in the first trimester. All the children had eye abnormalities. These included external eye lesions, Peters' anomaly, lens opacification, ocular motility disorders, and optic nerve hypoplasia.Fetal alcohol syndrome is characterised by at least three of the following findings: (1) A 6-month-old boy was born at 41 weeks gestation with meconium grade 3. He had a marked bradycephaly, developmental delay, a right congenital dislocation of hip, and an inguinal
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