IOL Power Choice in Children

The choice of IOL power for a child should take into consideration the myopic shift that results from ocular growth with age. The goal of cataract surgery in children is twofold: optimal management of vision in childhood and emmetropia in adult life. The former requires spectacles to manage the changing refractive error in the growing eye, as well as often-intensive treatment for amblyopia. The latter requires a combination of careful choice of the initial postoperative refraction based on age, with a goal of achieving an adult refractive error that can be easily managed with spectacles or contact lenses. Ideally, a child should have a small amount of initial hypermetropia. The growth of the eye follows a logarithmic curve with age. The eye grows as the child grows: rapidly at first, then slowing down over time. This growth induces a myopic shift.