Preventive Atropine Therapy For Myopia Control In Older Children With Cataract Implantation Of Advanced Monofocal Or Edof Iols: An 18-Month Follow-Up Study
Published 2023 - 41st Congress of the ESCRS
Reference: PP16.04 | Type: Free paper | DOI: 10.82333/b78x-e733
Authors: Aditya Sethi* 1 , Reena Sethi 2 , Vaibhav Sethi 3 , Sahebaan Sabharwal Sethi 4
1Pediatric Ophthalmology, Cataract and Refractive Surgery,Arunodaya Deseret Eye Hospital,Gurgaon,India;Comprehensive,Dr Sethi's Eye Center,Delhi,India, 2Cataract and IOL Department,Arunodaya Deseret Eye Hospital,Gurgaon,India;Comprehensive,Dr Sethi's Eye Center,Delhi,India, 3Vitreo Retinal Services,Arunodaya Deseret Eye Hospital,Gurgaon,India;Vitreo Retinal Services,Dr Sethi's Eye Center,Delhi,India, 4Glaucoma, Cataract and IOL Services,Arunodaya Deseret Eye Hospital,Gurgaon,India;Glaucoma, Cataract and IOL Services,Dr Sethi's Eye Center,Delhi,India
Purpose
This study aimed to investigate the benefits of advanced monofocal and EDOF IOLs in older children with cataract and to evaluate the effectiveness of preventive atropine therapy in controlling myopia progression after implantation. Thereby maximising long term outcomes with a required range of vision for effective development in the modern technology driven world.
Setting
This prospective study was conducted at a tertiary eye care center in the National Capital Region, Delhi, India over a span of 18 months, from January 2021 to June 2022. The study included children between the ages of 12 to 16 years, who were diagnosed with pediatric cataract and underwent advanced monofocal or EDOF IOL implantation. The study was approved by the institutional ethics committee and all parents or guardians provided written informed consent for their child's participation.
Methods
This prospective study involved 12 eyes of 9 children aged between 12-16 years with bilateral or unilateral cataract & no other ocular morbidities. All eyes were implanted with EDOF IOL(LUCIDUS/MINIWELL) or advanced monofocal(ADTEC COMFORT/EYHANCE). All IOLs were without multiple diffractive rings implanted in a safe pediatric cataract surgery. Before & After implantation, children underwent repeated optical biometry(OA 2000D TOMEY, PREOP with an aim to correct for emmetropia), & data was collected on axial length, corneal topography, ACD, IOP, fundus examination, and visual acuity were recorded every month for 18 months. Low-dose atropine was administered prophylactically from the early postoperative period, to counter myopia progression.
Results
All 12 eyes showed improvement to 6/6 unaided vision within 6 weeks after implantation, and intermediate vision was n6 at 40-50cm, while near vision was n8 for 33cm in advance monofocals and at N6 33cm with the EDOFs at 6 weeks. Myopia progression was stabilized with the use of atropine diluted drops, and only one eye out of 12 eyes showed progression of -0.75 Ds over 18months, and this patient was started on higher concentration atropine and myopia glasses. The mean increase in axial length from preoperative recording to final follow-up was 0.32 +/- 0.30 mm.
Conclusions
Our study suggests that advanced monofocal and EDOF IOLs are beneficial in older children with cataract. The preventive use of atropine therapy can be effective in controlling myopia progression after implantation of these IOLs. Our findings highlight the importance of regular follow-up and the need for further research to validate the long-term effectiveness of atropine therapy in controlling myopia progression in this patient population.
Financial disclosure of all authors: The authors declare no financial interests or conflicts of interest related to this study.