Anterior chamber phakic intraocular lens implantation in children to treat severe anisometropic myopia and amblyopia: 3-year clinical results

Abstract

To evaluate the midterm efficacy of Verisyse anterior chamber phakic intraocular lens (AC pIOL) implantation in reducing clinically significant (>-8.0 diopters) myopic anisometropia in children who have been noncompliant with traditional medical treatment. Private practice in affiliation with San Diego Children's Hospital, San Diego, California, USA. A retrospective interventional chart review identified highly anisometropic myopic pediatric patients in a single practice who had AC pIOL implantation in the more myopic eye. None of the patients were compliant with spectacle correction or contact lens therapy, and all had dense amblyopia. Preoperative and postoperative visual acuity, stereoacuity, central corneal thickness, motor alignment, and endothelial cell counts were performed in all patients. Occlusion therapy was initiated subsequent to pIOL implantation. The review identified 7 patients ranging in age from 5 to 11 years; the postoperative follow-up was 34 to 36 months. All patients had a significant improvement (>6 lines) in visual acuity postoperatively. The mean corrected distance visual acuity was 20/40 at 3 years. All patients had improved stereoacuity Randot testing, from a mean of 0 seconds of arc preoperatively to a mean of 185 seconds of arc at 3 years. No intraoperative or postoperative complications were identified. Results indicate that AC pIOL implantation can be considered an alternative modality to manage clinically significant, severe anisometropic myopia in pediatric eyes when there is poor patient compliance with traditional medical treatment. Long-term follow-up of corneal endothelial cell density after pediatric AC pIOL implantation is strongly encouraged.