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Choice of an appropriate refractive target for pediatric intraocular lens implantation requires consideration of a number of factors that are specific to infancy and childhood. The expected gradual myopic postoperative shift has led many surgeons to aim for an early postoperative refraction considerably on the plus side of emmetropia in hopes of avoiding substantial myopia at maturity. Younger age at time of surgery increases the likelihood of this phenomenon. Another important consideration, however, is the potential impact of early “pseudohyperopia” on visual development. Without accommodation, noncompliance with hyperopic correction early after surgery can compromise outcomes. Targeting initial emmetropia can in certain circumstances be an alternative strategy.
KeywordsCataract surgery Infant Child Intraocular lens Target Refraction Myopia Pseudohyperopia Amblyopia
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