We read with interest the article “Biometric changes in Indian pediatric cataract and postoperative refractive status” by Khokhar et al.[1] The authors have commendably evaluated the biometric changes in Indian pediatric cataract and this contributes well to the present literature.
We seek information on the following points which would give further clarity to the readers:
Was there any relationship between the laterality of cataract and axial length growth? In some publications of ocular growth and pediatric cataract, laterality is a useful variable in predicting axial length growth.[2,3] As the authors have data of both unilateral and bilateral cataracts, this would be a useful addition to literature. Moreover, lesser undercorrection is done in unilateral cataracts as there are increased chances of dense amblyopia not only due to laterality but also due to anisometropia and unilateral loss of accommodation following surgery[4]
The authors have mentioned first postoperative refraction on day 1 post surgery. Does that mean that on 1st day repeat general anaesthesia (GA) was given? Also the reliability of refraction is expected to be suboptimal taking into account the 1st day effects on (a) cornea—recent incision, suture, and hydration; (b) anterior chamber—presence of air, residual visco elastic, or balanced salt solution; and (c) intraocular pressure
While the percentage reduction achieved in different groups is clear, which nomogram has been used preoperatively to achieve the same is unclear. Moreover, is it appropriate to use Sanders, Retzlaff, Kraff (SRK) II formula for all axial lengths >17 mm?[5]
Although 6 months follow-up has been mentioned as a limitation, nevertheless this study does cover the crucial period during which the eye is undergoing most rapid phase of axial growth in infants. It would be useful to continue the follow-up of these children to reach more meaningful conclusions.
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Conflicts of interest
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References
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