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Nicholas Faron, James Hoekel, Lawrence Tychsen; Outcomes of iris-enclaved Artisan-Verisyse intraocular lens implantation in children with high ametropia. Invest. Ophthalmol. Vis. Sci. 2015;56(7 ):687.
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© ARVO (1962-2015); The Authors (2016-present)
Reports of iris-enclaved phakic IOL implantation performed on children to correct high ametropia have been limited to small series or case reports. Here we analyze outcomes in a sizeable number of children and adolescents treated by implantation of a phakic IOL.
Clinical outcome data were collated prospectively in 115 phakic eyes of 78 children (37 bilateral & 41 unilateral). 90% of the patients had a preexisting neurobehavorial disorder and/or visuomotor co-morbidities. All children had difficulties with contact lenses or spectacle wear. Mean age at surgery was 9.7 yrs (range 1-22); mean follow-up was 4.1 yrs (range 1-9).
Spherical correction averaged -14.25. 97% of eyes were corrected to within ±0.5D of their target value; all were corrected to within ±1.0D. Refractive spherical regression was 0.11D/yr after 2 years and 0.05D/yr at last follow-up. Uncorrected visual acuity improved from an average logMAR 1.59 (20/786) to 0.35 (20/45); best corrected visual acuity improved an average of 0.24 logMAR. 65% of children treated had a gain in at least one level of binocular fusion. Corneal endothelial cell density (ECD) decreased an average of 3% per year over a span of 3 years. 1.7% of the treated eyes required an IOL explant or exchange.
Implantation of the Artisan-Verisyse phakic IOL reduced refractive error and improved visual acuity substantially. The IOL was well-tolerated in the majority of the children. A decrease in corneal ECD is known to occur after implantation of any IOL and is explained in part by the increasing age of the patient. The Artisan-Verisyse IOL is an effective method for improving visual function in highly ametropic children who have difficulties wearing contact lens or spectacles.
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