July 2018
Volume 59, Issue 9
Open Access
ARVO Annual Meeting Abstract  |   July 2018
Refractive Lens Exchange in 39 Special-Needs Children and Adolescents
Author Affiliations & Notes
  • Lawrence Tychsen
    Ophthal and Neurobio-Childrens Hosp, Washington Univ School of Medicine, St Louis, Missouri, United States
  • Nicholas Faron
    Ophthal and Neurobio-Childrens Hosp, Washington Univ School of Medicine, St Louis, Missouri, United States
  • James Hoekel
    Ophthal and Neurobio-Childrens Hosp, Washington Univ School of Medicine, St Louis, Missouri, United States
  • Footnotes
    Commercial Relationships   Lawrence Tychsen, None; Nicholas Faron, None; James Hoekel, None
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science July 2018, Vol.59, 3165. doi:
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      Lawrence Tychsen, Nicholas Faron, James Hoekel; Refractive Lens Exchange in 39 Special-Needs Children and Adolescents. Invest. Ophthalmol. Vis. Sci. 2018;59(9):3165.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose : Reports of using refractive lens exchange (RLE) to treat myopic refractive errors in children have been limited to case reports. We analyze outcomes in a series of children who were noncompliant with spectacles or contact lenses and had neurologic as well as visuomotor disorders.

Methods : Clinical outcome data were collated prospectively in 39 myopic children (68 eyes) treated for isoametropic or anisometropic refractive error using refractive lensectomy with or without IOL implantation. 66% of the patients were premature (≤ 30 wks GA) and 69% had retinopathy of prematurity. The mean age at refractive surgery was 8.3 years (range 1.5 to 22); mean follow-up was 2.8 years (range 1-15 years).

Results : Myopic spherical equivalent averaged -15.62 ±6.9D (range -7.75 to -30) and was corrected to 0.60±1.34D at 1-year follow-up. After 5 years, refractive regression was -0.23D/yr in myopes. Corrected Distance Visual Acuity (CDVA) improved 0.26 logMAR (20/87 to 20/48); Uncorrected Distance Visual Acuity (UDVA) improved 0.66 logMAR (20/285 to 20/62). 64% of children treated had a gain in at least one level of binocular fusion.

Conclusions : Refractive lens exchange is an effective means for improving visual function and quality of life in highly myopic children who have difficulties wearing spectacles. Visual acuity increased and refractive error decreased substantially from preoperative levels.

This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.

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