Primary and Secondary Intraocular Lens Implantations in Children With Pediatric Cataract: Visual Acuity and Strabismus at the Age of 2 Years and Older

To compare the visual outcomes of primary and secondary intraocular lens (IOL) implantations and to identify the risk factors for the development of strabismus in patients with pediatric cataract.The records of the pediatric patients who had undergone cataract surgery between January 1999 and November 2014 were reviewed retrospectively. The results of the cases with cataract extraction with primary IOL implantation (primary group) and cases with secondary IOL implantation (secondary group) were compared and the risk factors for the development of strabismus were investigated.This study included 220 eyes of 148 patients who had surgery for pediatric cataract. The mean age of the patients was 6.84 ± 3.45 years (range: 2 to 17 years) for the primary group at the time of cataract extraction and primary posterior chamber IOL implantation and 8.92 ± 5.12 years (range: 2 to 18 years) for the secondary group at the time of secondary IOL implantation (P = .118). Strabismus developed in 28 patients (23.73%) in the primary group and 9 patients (30%) in the secondary group (P = .702). At the last postoperative examination, Snellen visual acuity was 0.44 and 0.28 for the primary and secondary groups, respectively (P = .013). There was a negative relationship between visual acuity and the development of strabismus (P = .048), whereas there was a positive relationship between the follow-up period and the development of strabismus (P = .008).Optic rehabilitation of the pediatric cataract is an important factor in the development of strabismus. These cases should be monitored closely. [J Pediatr Ophthalmol Strabismus. 2017;54(2):97-102.].