Case Reports

Bilateral toric-IOL implantation in a 10 year-old girl: clinical assessment and visual rehabilitation, through adulthood

Case Report Details

First Author: A.Kanellopoulos GREECE

Co Author(s):                        

Abstract Details

Purpose:

To report the safety, efficacy and long-term follow-up of clear cornea small-incision cataract extraction and toric IOL implantation in a pediatric patient.

Setting:

LaserVision Clinical and Research Eye Institute

Report of Case:

A ten-year old girl with hyperopic astigmatism that had presented initially at 6 with visually significant bilateral cataracts was followed initially conservatively for 4 years. When her symptoms interfered with her schooling and other activities, Clear cornea small-incision cataract extraction was completed with toric-IOL implantation. An AcrySof power: +27.0, model SN60T5 was placed at the 96° meridian in the OD, and a + 28.0 SN60T4 was implanted at the 73° meridian in the OS under general anesthesia. Acuity, refraction, ECD, UDVA, CDVA, corneal Scheimpflug tomography were evaluated with follow-up of 14 years, past of her becoming an adult. UDVA improved from 20/400 in both eyes, to 20/20 in the OD and 20/40 in the OS. Corneal tomography symmetric astigmatism of 2.6 diopters and 2 diopters in respectively. Refraction improved from +3.5 -1.5 @ 170 degrees to -0.25 -0.50 @ 175 degrees and from +4.25 -1.00 @ 10 degrees to -1.00 -0.75 @ 5 degrees. Nd:YAG capsulotomy was performed 30 months later OU without further incident or any additional intervention needed.

Conclusion/Take Home Message:

Pediatric cataract surgery can employ foldable toric IOL as an alternative solution to ametropia and long-term visual rehabilitation. This approach remains off-label in many countries and proper parent education and consent is appropriate.

Financial Disclosure:

None