Seven-year follow-up of unilateral multifocal pseudophakia in a child

Abstract

The purpose of the study was to report the long-term outcome of unilateral implantation of a multifocal intraocular lens (IOL) in a pediatric cataract. This study was carried out at Tertiary Academic Ophthalmology Department, AMC, Amsterdam. This is a case report study of a 7-year-old child with a unilateral irradiation cataract, in whom an apodized diffractive multifocal IOL (SN6D3, Alcon) was implanted at the time of cataract surgery. During the follow-up period, visual acuity was preserved at logMAR -0.1; the child did not develop amblyopia. Binocular single vision was established. Few glistenings were seen on the IOL. The non-operated eye developed more myopia during the follow-up period than the multifocally implanted eye. Straylight was increased to log(s) 1.83. Patient and parents satisfaction were high. In selected cases, unilateral implantation of apodized diffractive multifocal IOLs leads to good long-term results in terms of visual acuity and patient satisfaction. No untoward effects were seen, including few glistenings on the IOL. Straylight is increased, but subjectively not disturbing.

Premium intraocular lenses in children

“…Articles with outcomes unrelated to our topic, letters to editors and commentaries were excluded. A total of 17 studies (case reports, [12][13][14][15][16][17] case series 18 and interventional studies) were then evaluated in detail. Full text and reference lists of all these were screened to ensure that any relevant study was not excluded.…”

Commentary review: challenges of intraocular lens implantation for congenital cataract infants

“…Considering that the capsular bag diameter of infants is limited, IOLs with two open haptics are the first choice because of their good deformability and adaptive capacity in capsular bag. Furthermore, about the application of multifocal IOLs and toric IOLs, although it has been reported occasionally, the safety and effectiveness of these IOLs in children still remains unclear [51][52] . Positions of IOL Implantation Capsular bag and sulcus are the most common positions to place IOL.…”

Innovations in pediatric cataract surgery

“…[51] The “Perfect” IOL would be with a hydrophilic anterior surface and a hydrophobic posterior surface. Multifocal IOLs provide good near and distance vision[52] and also help in establishing stereopsis in unilateral cases,[53] but the brightness and contrast of the images get compromised. [52] Any decentration of lens leads to glare, halos, and deterioration in the quality of the image.…”