Objective: To compare the rate of refractive growth in pseudophakic children's eyes to that of aphakic eyes. Design: Multicenter, retrospective observational case series. Participants: 83 patients with pseudophakic eyes (100 eyes) and 74 patients with aphakic eyes (106 eyes), with an age of surgery between 3 months and 10 years and a minimum follow-up time of 3 years or more, depending on the age at surgery. Methods: A logarithmic model was used to analyze the rate of refractive growth for each eye. Main Outcome Measures: Age at surgery, intraocular lens power, intraocular lens A- constant, initial postoperative refraction, final refraction, and final age. Results: Overall, pseudophakic eyes showed a lesser rate of refractive growth than aphakic eyes (-4.6 diopter vs. -5.7 diopter, P = 0.03). This trend was also present but less significant when the eyes were grouped into those less than 6 months of age at surgery (-3.3 diopter vs. -4.6 diopter, P = 0.09) and older patients (-5.0 diopter vs. -6.1 diopter, P = 0.07). However, the mean quantity of myopic shift was greater in pseudophakic eyes than in aphakic eyes (-5.26 diopter vs. -4.54 diopter), despite shorter follow-up times in the pseudophakic eyes. This is due to the optical effects of a constant intraocular lens power in a growing eye. Conclusions: Pediatric pseudophakic eyes have a slightly lesser rate of refractive growth than aphakic eyes. The new rate values should be used for predicting future refractions in these eyes. (C) 2000 by the American Academy of Ophthalmology.
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