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Bilateral implantation of multifocal versus monofocal intraocular lens in children above 5 years of age

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Abstract

Purpose

To evaluate visual results and complications after bilateral implantation of multifocal versus monofocal intraocular lens (IOL) in children above five years of age.

Methods

In this prospective non-randomized controlled trial, children with bilateral developmental cataract above five years of age were divided into two groups – Group A implanted with multifocal IOL (both refractive and diffractive) and Group B implanted with monofocal IOL in both eyes. Outcome measures of best corrected visual acuity (BCVA) for distance, distance-corrected near visual acuity (DCNVA), mean refractive spherical equivalent (MRSE), contrast sensitivity, stereopsis and complications such as posterior capsular opacification (PCO) and glare were analyzed using the Mann–Whitney U and the Wilcoxon Signed Rank tests.

Results

Forty-two eyes of 21 children (mean age: 7.19 years, range: 5–12 years) were included in the study. Group A included 14 eyes (seven children) Group B included 28 eyes (14 children). Both groups showed significant improvement in BCVA at one year follow-up, but no significant difference was found on comparing contrast sensitivity. Stereopsis was slightly better in Group A (125.71 arc-sec) as compared to Group B (140 arc-sec) (p = 0.280). Most patients in Group A were spectacle-independent for near (71.4 %) versus Group B. MRSE at one year was 0.21 in Group A and 0.5 in Group B. Incidence of PCO was similar in either groups (35.7 %). No intraoperative complication was noted in any child.

Conclusion

Multifocal IOL implantation is a viable option in children above five years of age with bilateral cataract.

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References

  1. Foster A, Gilbert C, Rahi J (1997) Epidemiology of cataract in childhood: a global perspective. J Cataract Refract Surg 23:601–604

    Article  PubMed  Google Scholar 

  2. Brady KM, Atkinson CSD, Kilty LA, Hiles DA (1995) Cataract surgery and intraocular lens implantation in children. Am J Ophthalmol 120:1–9

    CAS  PubMed  Google Scholar 

  3. Ram J, Brar GS, Kaushik S, Sukhija J, Bandyopadhyay S, Gupta A (2007) Primary intraocular lens implantation in the first two years of life: safety profile and visual results. Indian J Ophthalmol 55:185–189

    Article  PubMed  Google Scholar 

  4. Wilson ME (1996) Intraocular lens implantation. Has it become the standard of care for children? Ophthalmology 103:1719–1720

    Article  CAS  PubMed  Google Scholar 

  5. Ram J, Gupta N, Sukhija J, Chaudhary M, Verma N, Kumar S, Severia S (2011) Outcome of cataract surgery with primary intraocular lens implantation in children. Br J Ophthalmol 95:1086–1090

    Article  PubMed  Google Scholar 

  6. Tassignon MJ, De Veuster I, Godts D et al (2007) Bag-in-the-lens intraocular lens implantation in the pediatric eye. J Cataract Refract Surg 33:611–617

    Article  PubMed  Google Scholar 

  7. Tassignon MJ, Gobin L, De Veuster I, Godts D (2009) Advantages of the bag-in-the-lens intraocular lens in pediatric cataract surgery. J Fr Ophtalmol 32:481–487

    Article  PubMed  Google Scholar 

  8. Gray PJ, Lyall MG (1992) Diffractive multifocal intraocular lens implants for unilateral cataracts in prepresbyopic patients. Br J Ophthalmol 76:336–337

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  9. Alfonso JF, Ferna’ndez-Vega L, Baamonde MB, Monte’s-Mico’ R (2007) Prospective visual evaluation of apodized diffractive intraocular lenses. J Cataract Refract Surg 33:1235–1243

    Article  PubMed  Google Scholar 

  10. Alfonso JF, Ferna’ndez-Vega L, Valca’rcel B, Monte’s-Mico’ R (2008) Visual performance after AcrySof ReSTOR aspheric intraocular lens implantation. J Optom 1:30–35

    Article  Google Scholar 

  11. Gimbel HV, Sanders DR, Raanan MG (1991) Visual and refractive results of multifocal intraocular lenses. Ophthalmology 98:881–887

    Article  CAS  PubMed  Google Scholar 

  12. Leyland M, Zinicola E (2003) Multifocal versus monofocal intraocular lenses in cataract surgery: a systematic review. Ophthalmology 110:1789–1798

    Article  PubMed  Google Scholar 

  13. Vaquero M, Encinas JL, Jiminez F (1996) Visual function with monofocal versus multifocal IOLs. J Cataract Refract Surg 22:1222–1225

    Article  CAS  PubMed  Google Scholar 

  14. Cillino S, Cassuccio A, Di Pace F, Morreale R, Pillitteri F, Cillino G, Lodato G (2008) One-year outcomes with new-generation multifocal intraocular lenses. Ophthalmology 115:1508–1516

    Article  PubMed  Google Scholar 

  15. Jacobi P, Dietlein T, Konen W (2001) Multifocal intraocular lens implantation in pediatric cataract surgery. Ophthalmology 108:1375–1380

    Article  CAS  PubMed  Google Scholar 

  16. Cristobal J, Remon L, Angeles Del Buey M, Montes-Mico R (2010) Multifocal intraocular lenses for unilateral cataract in children. J Cataract Refract Surg 36:2035–2040

    Article  PubMed  Google Scholar 

  17. Andreo LK, Wilson ME, Saunders RA (1997) Predictive value of regression and theoretical IOL formulas in pediatric intraocular lens implantation. J Pediatr Ophthalmol Strabismus 34:240–243

    CAS  PubMed  Google Scholar 

  18. Abouzeid H, Moetteli L, Munier F (2013) New-generation multifocal intraocular lens for pediatric cataract. Ophthalmologica 200:100–107

    Article  Google Scholar 

  19. Vasavada A, Raj S, Nihalani B (2004) Rate of axial growth after congenital cataract surgery. Am J Ophthalmol 138:915–924

    Article  PubMed  Google Scholar 

  20. Wilson ME, Trivedi RH, Burger BM (2009) Eye growth in the second decade of life: implications for the implantation of a multifocal intraocular lens. Trans Am Ophthalmol Soc 107:120–126

    PubMed Central  PubMed  Google Scholar 

  21. Olsen T, Corydon DL (1990) Contrast sensitivity as a function of focus in patients with the diffractive multifocal intraocular lens. J Cataract Refract Surg 16:703–706

    Article  CAS  PubMed  Google Scholar 

  22. Hütz WW, Eckhardt HB, Röhrig B, Grolmus R (2006) Reading ability with 3 multifocal intraocular lens models. J Cataract Refract Surg 32:2015–2021

    Article  PubMed  Google Scholar 

  23. Renieri G, Kurz S, Schneider A, Eisenmann D (2007) ReSTOR® diffractive versus Array® 2 zonal-progressive multifocal intraocular lens: a contralateral comparison. Eur J Ophthalmol 17:720–728

    CAS  PubMed  Google Scholar 

  24. Von Noorden GK (2002) Binocular vision and ocular motility: theory and management of strabismus. Mosby, St. Louis

    Google Scholar 

  25. Messer DH, Mitchell GL, Twelker JD, Crescioni M (2012) Spectacle wear in children given spectacles through a school-based program: CLEERE study group. Optom Vis Sci 89:19–26

    Article  PubMed Central  PubMed  Google Scholar 

  26. Castanon Holguin AM, Congdon N, Patel N et al (2006) Factors associated with spectacle-wear compliance in school-aged Mexican children. Investig Ophthalmol Vis Sci 47:925–928

    Article  Google Scholar 

  27. Gogate P, Mukhopadhyaya D, Mahadik A, Naduvilath TJ, Sane S, Shinde A, Holden B (2013) Spectacle compliance amongst rural secondary school children in Pune district, India. Indian J Ophthalmol 61:8–12

    Article  PubMed Central  PubMed  Google Scholar 

  28. Ram J, Brar GS, Kaushik S, Gupta A, Gupta A (2003) Role of posterior capsulotomy with vitrectomy and intraocular lens design and material in reducing posterior capsule opacification after pediatric cataract surgery. J Cataract Refract Surg 29:1579–1584

    Article  PubMed  Google Scholar 

  29. Elgohary MA, Beckingsale AB (2008) Effect of posterior capsular opacification on visual function in patients with monofocal and multifocal intraocular lenses. Eye 22:613–619

    Article  CAS  PubMed  Google Scholar 

  30. Montés-Micó R, López-Gil N, Pérez-Vives C, Bonaque S, Ferrer-Blasco T (2012) In vitro optical performance of non-rotational symmetric and refractive-diffractive aspheric multifocal intraocular lenses: impact of tilt and decentration. J Cataract Refract Surg 38:1657–1663

    Article  PubMed  Google Scholar 

  31. Amadieh H, Javadi MA, Ahmady M et al (1999) Primary capsulectomy, anterior vitrectomy, lensectomy, and posterior chamber lens implantation in children: limbal versus pars plana. J Cataract Refract Surg 25:768–775

    Article  Google Scholar 

  32. Vasavada AR, Praveen MR, Tassignon MJ et al (2011) Posterior capsule management in congenital cataract surgery. J Cataract Refract Surg 37:173–193

    Article  PubMed  Google Scholar 

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Correspondence to Jagat Ram.

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Ram, J., Agarwal, A., Kumar, J. et al. Bilateral implantation of multifocal versus monofocal intraocular lens in children above 5 years of age. Graefes Arch Clin Exp Ophthalmol 252, 441–447 (2014). https://doi.org/10.1007/s00417-014-2571-0

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  • DOI: https://doi.org/10.1007/s00417-014-2571-0

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