Pediatric phakic intraocular lens surgery: review of clinical studies

Pirouzian, Amir

doi:10.1097/icu.0b013e32833a9a9f

Cited by 18 publications

(8 citation statements)

References 48 publications

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“…Although PIOL implantation for myopia correction in adults proved to be safe and effective, 1,9,12 performing surgery in pediatric patients may be somewhat controversial. People are concerned that PIOL implantation in children may cause complications such as acute or chronic inflammation, glaucoma, cataract, or a Abbreviations: ACD, anterior chamber depth; AL, axis length; BCVA, best corrected visual acuity in LogMAR; CED, corneal endotheliam density (cells/mm 2 ); PIOL, phakic intraocular lens; SE, spherical equivalent power; UCVA, uncorrected visual acuity in LogMAR.…”

Section: Discussionmentioning

confidence: 99%

Posterior sclera reinforcement and phakic intraocular lens implantation for highly myopic amblyopia in children: a 3-year follow-up

Zhu

et al. 2014

Eye

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Purpose To study the safety and efficacy of posterior scleral reinforcement (PSR) combined with phakic intraocular lens (PIOLs) implantation for highly myopic amblyopia in children. Methods This study included eight highly myopic children (11 eyes) who failed in conventional therapy for amblyopia using various combination of spectacles, contact lenses, and intensive patching before enrollment into this study. They were treated sequentially with PSR and PIOL implantation, and were followed up for 3 years after surgery. Uncorrected visual acuity (UCVA) and best corrected visual acuity (BCVA) in LogMAR, spherical equivalent power (SE), and complications were evaluated. Results Before surgery, the mean UCVA was 1.59 ± 0.33, BCVA, 0.74 ± 0.37, SE, À 17.57 ± 5.56D, the axial length (AL), 30.09±2.18 mm. After PSR, BCVA improved one line in three patients, the rest were unchanged, and AL was unchanged among all cases. Six eyes of three patients were implanted with an iris-claw PIOL and five eyes of five patients were implanted with a posterior PIOL. After completion of treatment, the mean UCVA was 0.44 ± 0.21, BCVA 0.38±0.24, SE À 0.54±0.74 D, and AL 30.35±2.29 mm. No patient experienced complications. Conclusion Combined PSR and PIOL implantation treatment for highly myopic amblyopia in children is safe and effective.

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Section: Discussionmentioning

confidence: 99%

Posterior sclera reinforcement and phakic intraocular lens implantation for highly myopic amblyopia in children: a 3-year follow-up

Zhu

et al. 2014

Eye

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“…Different models of IOLs have been successfully implanted in children with severe anisometropic amblyopia, but concern remains regarding unforeseen long-term side effects. [4142]…”

Section: Phakic Intraocular Lenses In the Pediatric Age Groupmentioning

confidence: 99%

Phakic intraocular lenses and their special indications

Pineda¹,

Chauhan²

2016

J Ophthalmic Vis Res

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“…43 Anterior chamber depth is an important consideration, with a depth of 3.2 mm or more required for safe insertion and lower long-term risk of endothelial cell loss. The preference currently appears to be for iris-fixated anterior chamber IOLs.…”

Section: Phakic Iol Implantsmentioning

confidence: 99%

Refractive Surgery in Children

Moran

O’Keefe²

2012

Asia-Pacific Journal of Ophthalmology

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Refractive surgery in children is controversial. The main indications are bilateral high ametropia and anisometropia where conventional treatment with spectacles or contact lens is not tolerated. Other reported indications include accommodative strabismus and previous cataract surgery. The most commonly performed procedures currently are surface ablation procedures using excimer laser. The main disadvantage of surface ablation procedures is refractive regression, which is more pronounced in higher degrees of ametropia. More recently, there is a growing number of studies evaluating the safety and effectiveness of phakic intraocular lenses (IOLs) as an alternative surgical management for children who are noncompliant with conventional treatment and unsuitable for laser ablative procedures. The advantages of phakic IOLs are reversibility, predictability, and lack of regression. The principal concern with phakic IOL insertion is long-term endothelial cell loss. Clear lens extraction has been performed in patients with shallow anterior chambers beyond the range of corneal laser refractive procedures; however, major drawbacks include loss of accommodation and significant risk of retinal detachment. In summary, results to date show that refractive surgery can be successfully performed in children and meets an important need in a select subgroup of patients who are recalcitrant to traditional therapy. Issues that remain controversial are the age at which to perform surgery, choice of procedure, need for anesthesia, instability of refractive errors in children, and long-term safety considerations.

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Pediatric phakic intraocular lens surgery: review of clinical studies

Cited by 18 publications

References 48 publications

Posterior sclera reinforcement and phakic intraocular lens implantation for highly myopic amblyopia in children: a 3-year follow-up

Posterior sclera reinforcement and phakic intraocular lens implantation for highly myopic amblyopia in children: a 3-year follow-up

Phakic intraocular lenses and their special indications

Refractive Surgery in Children

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