Multifocal Intraocular Lens Implantation In Pediatric Patients

To present the outcomes of Multifocal Intraocular lens (MF-IOL) implantation in pediatric population.   

Children aged 6 and over undergoing bilateral cataract extraction surgery with MF-IOL implantation were included in the study. 

Preoperative data included corrected distance visual acuity (CDVA) testing, slit lamp and funduscopic examination findings and intraocular pressure measurements. Biometry was recorded with IOL Master 700 (Carl Zeiss Meditec AG) and corneal topography data was acquired using Pentacam (Oculus, Wetzlar, Germany) machine prior to surgery. IOL power calculation was made through Barrett Universal II (BUII) and Kane calculators with target refraction aiming for emmetropia. Anterior vitrectomy was performed when indicated. Postoperative evaluation included uncorrected and corrected distance and near visual acuity (UDVA & CDVA, UNVA & CNVA, respectively), stereopsis evaluation and manifest refraction.

14 eyes of 7 children with a mean age of 11.6 ± 2.7 years (range 7.6 – 15.6 years) were included. Mean follow up was 13.5 ± 12.9 months (range 0.67 – 38.2 months). 7 eyes were implanted with a MF IOL and 7 eyes with a multitoric IOL. All eyes demonstrated an improvement in visual acuity and spectacle independence. Mean CDVA prior to surgery was 0.47 ± 0.22 Logarithm of the Minimum Angle of Resolution (range 0.18- 0.88 LogMar). At last follow-up, mean UDVA was 0.12 ± 0.10 LogMar (range 0.00 - 0.30 LogMar, p= 0.0017) and mean UNVA was 0.15 ± 0.16 logMar (range 0.00-0.54 logMar). Mean postoperative manifest refraction spherical equivalent was -0.07 ± 0.56D (range; -1.25 – +0.75). None reported halos or glare. No IOL decentration was observed.

Multifocal IOLS implantation is a viable option in selected pediatric patients undergoing cataract surgery. If needed, vision can be corrected postoperatively with monofocal glasses.