Abstract
Purpose :
Reports of using toric phakic intraocular lenses (T-Ph IOLs) to treat compound myopic & hyperopic astigmatism in children are few. Here we report use of T-Ph IOLs to treat a series of children with amblyopiogenic astigmatism who had difficulties with spectacle or contact lens wear.
Methods :
Clinical outcome data were collated prospectively in 6 myopic-astigmatic children (11 eyes) and 2 hyperopic-astigmatic children (4 eyes) treated for isoametropic or anisometropic amblyopia using T-Ph IOLs. Three children had cerebral palsy, two had developmental delay, two had a history of extreme prematurity with ROP, and three had encephalopathy-related optic neuropathy. The mean age at refractive surgery was 13.1 yrs (range 7 to 19 yrs); mean follow-up was 1.82 years (range 1-3.5 yrs).
Results :
Myopic spherical refractive error averaged -7.1 ± 3.5 D (range -3 to -12 D) and hyperopic spherical error averaged + 9.1 ± 1.0 D (range 7.8 to 19 D). Average astigmatism in myopes was 5.4 ± 1.6 D (range 2.5 to 8 D) and in hyperopes 3.9 ± 0.9 D (range 3 to 4.3 D). At last follow-up, spherical error was reduced to – 0.4 ± 0.7 D in myopes and + 0.38 ± 1.3 D in hyperopes. Astigmatic error was reduced to an average 1.5 ± 1.5 D in myopes and and 1.8 ± 1.5 D in hyperopes. Myopic and hyperopic UCVA improved 1.05 logMAR and 1.0 logMAR; CDVA improved 0.12 logMAR & 0.06 logMAR, respectively. One eye required re-enclavation of an IOL haptic following blunt eye trauma and one eye required additional treatment using excimer laser PRK for residual ametropia. Endothelial cell density measurements did not show accelerated loss.
Conclusions :
Toric phakic IOL refractive surgery is an effective means for improving visual function and quality of life in highly ametropic children who have difficulties wearing spectacles. Visual acuity improved substantially and refractive error reduced substantially compared to pre-operative measurements.
This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.