Phakic intraocular lens (Verisyse) implantation for correction of severe anisometropia in pediatric patients

Poster Details

First Author: R.Autrata CZECH REPUBLIC

Co Author(s):    I. Krejcirova   K. Senkova           

Abstract Details

Purpose:

Our study evaluated safety and efficacy of Verisyse™ (AMO) phakic anterior chamber intraocular lens (IOL) in the correction of significant myopic (>-10 D) or hyperopic anisometropia (> +7D) in children who are noncompliant to conventional treatment with spectacle correction or contact lenses.

Setting:

Department of Ophthalmology, Faculty of Medicine, Masaryk University, Faculty Hospital Brno, 613 00 Brno, Czech Republic,

Methods:

18 children with myopic anisometropia (range –11 to –18 D, SE) and 7 patients with hyperopic anisometropia (range +6,5 to +9,5 D, SE) underwent unilateral Verisyse phakic IOL implantation under general anesthesia. All patients had chronic difficulties with spectacles due to aniseikonia or with contact lens intolerance. Pre- and post-operative visual acuity, cycloplegic refraction, anterior and posterior segment examination, axial biometry measurements, endothelial cell counts, stereoacuity and aniseikonia examinations were performed in all patients. Goal refraction was approximately 0 to -1 D. The mean age was 6,9 years; range 5-12 years. Mean follow-up was 14.5 months (range, 9-26 months). Our study was approved by the Institutional Hospital Review and Ethical Committee. The study and data collection were compliant with the principles of the Declaration of Helsinki. All children younger than 8 years underwent patching treatment of their dominant eye for 6 hours daily in the period of 6-15 months postoperatively.

Results:

The mean spherical equivalent cyloplegic refraction of myopic eyes changed from –15,6 D preoperatively to –0,79 D ( range: +0,5 to -1,75D) postoperatively. The mean hyperopia reduced from +7,84 D preop. to +0,92 (range: -0,75 až + 1,5). 83% of treated eyes were in the range ± 1,0 D of emetropia. The mean uncorrected visual acuity improved from 0,013 (log MAR 2,09 ±0,47) to 0,33 (logMAR 0,48± 0,21), t-test; P=0,0011. The mean best spectacles corrected visual acuity (BSCVA) changed from 0,27 (logMAR 0,59±0,14) to 0,61 (log MAR 0,19 ± 0,12), t-test; P=0,0223. The mean Safety Index (BSCVA postop/preop) was 2,25. Improvement in stereoacuity was reached in all 25 patients (from total mean zero seconds-arc to mean of 800 seconds-arc by randot stereoacuity testing in time of final examination). No patient lost any lines of visual acuity. No intra- or post-operative complications have been encountered.

Conclusions:

Anterior chamber phakic IOLs may provide a safe and effective alternative in management of highly anisometropic myopic and hyperopic children, who are noncompliant with conventional treatment with spectacles or contact lenses. Supported by grant of the Ministry of Health (IGA), Czech Republic, identification no. NT12110-5/2011 NS 9284 FINANCIAL DISCLOSURE?: No