New-Generation Multifocal Intraocular Lens for Pediatric Cataract

Abstract

Background/Aims: To evaluate multifocal intraocular lens (MIOL) implantation in children. Methods: This is a retrospective study evaluating refractive, visual and safety results of MIOL in pediatric cataract surgery. Average follow-up was 25.73 ± 10.5 months. Surgery included 12 o'clock clear corneal incision, anterior capsulorhexis, lens material aspiration and MIOL implantation (SN6AD3; Alcon). Results: We included 34 cataract eyes of 26 pediatric patients aged 2-15 years, of which 14 (54%) were unilateral. Best near visual acuity (BNVA) and best distance visual acuity (BDVA) improved significantly in 100% of eyes (p = 0.0001). BDVA was above 0.8 in 31.25% (5/16) of bilateral cases. Significant stereopsis improvement was observed postoperatively in bilateral cases only (p = 0.01). Conclusion: MIOL implantation is a safe alternative to monofocal pseudophakia for pediatric cataract with a very low complication rate. Significant BNVA, BDVA and stereopsis improvement can be achieved, particularly in bilateral cases. Message: This study shows significant BDVA, BNVA and stereopsis improvement, especially in bilateral cases, after MIOL implantation for pediatric cataracts.

Comparative analysis of visual outcomes of multifocal and monofocal intraocular lenses in congenital cataract surgery

“…Previous articles evaluated the safety and efficacy of multifocal IOLs in children affected by infantile cataract older than 2 years, showing they could represent a safe alternative to monofocal pseudophakia, providing visual acuity improvement and, mainly in bilateral cases, stereopsis, with a very low complication rate. 14–16…”

Premium intraocular lenses in children

“…Improvement in CDVA was seen in 70–100% of the patients in the majority of the studies. 6, 7, 37 The rate of spectacle independence for near was found to be comparable in most of the studies ranging from 70–80% in bilateral cases. 6 One of the first prospective studies by Jacobi et al .…”

“…Most of the series on multifocal IOLs used either clear corneal or limbal based incisions for entry and lens aspiration with or without a posterior capsulotomy and anterior vitrectomy depending on the age of the patient followed by IOL implantation. Patients less than 5 years underwent posterior curvilinear capsulorhexis (PCCC) in one series 37 and this age limit was kept as 8 years in another series. 6 Posterior capsulotomy was performed in 60–100% participants 7, 33 ; leaving the capsule intact was invariably seen to be associated with PCO formation.…”

Bilateral trifocal IOL implantation in a pediatric case of cataract following steroid-therapy for acute lymphoblastic leukemia

“…Patients yielded good results for distance and near vision and improvement in stereopsis with low complication rates. 17 In both studies the authors concluded that the implantation of MIOLs is a viable alternative to monofocal IOL implantation in pediatric cataract cases. 4 , 17 …”