Implantation of spherical and toric copolymer phackic intraocular lens to manage amblyopia due to anisometropic hyperopia and myopia in pediatric patients

Abstract

To evaluate the safety and efficacy of implantation of the Visian Implantable Collamer Lens phakic intraocular lens (pIOL) (spherical and toric models) for management of amblyopia due to anisometropic hyperopia and myopia in children. Retrospective case series. Tertiary care eye specialty hospital, Dhahran, Saudi Arabia. Eyes of patients who underwent the implantation of the pIOL for refractory anisometropic amblyopia were identified. None of the patients were compliant with spectacle/contact lens correction. Preoperative and postoperative clinical evaluation included visual acuity, cycloplegic refraction, slitlamp microscopy, intraocular pressure, orthoptic evaluation, anterior chamber depth, and ICL vault. A total of 11 eyes (9 myopic, 2 hyperopic) of 11 patients aged 5 to 15 years were identified. Of the 9 myopic eyes, 6 eyes received spherical ICLs and 3 received toric ICLs. Both hyperopic eyes received spherical ICLs. Preoperatively, the mean cycloplegic refractive spherical equivalent (CRSE) was -11.07 D (range -7.75 to -21.88 D) in myopic eyes, and +8.75 D (range +8.63 to +8.87 D) in hyperopic eyes. The mean corrected distance visual acuity (CDVA) was 20/171 (range 20/40 to 20/400) in myopic eyes, and 20/130 (range 20/60 to 20/200) in hyperopic eyes. At a mean follow-up of 16.8 months (in myopic eyes), the mean CRSE was -1.40 D (range 0 to -2.25 D), and mean CDVA was 20/51 (range 20/20 to 20/100). In hyperopic eyes, at a mean follow-up of 15 months, the mean CRSE was +1.82 D (range +1.75 to +1.88 D) and the CDVA had improved to 20/25 in both eyes. Although complications occurred in the 2 hyperopic eyes, the complications were either temporary or visually insignificant and did not necessitate reoperation or ICL explantation. ICL implantation may be considered a safe and effective treatment option for refractory amblyopia due to anisometropic hyperopia or myopia in children who are noncompliant with conventional therapy. The authors have no financial or proprietary interest in a product, method, or material described herein.