Uncorrected visual acuity in children with monofocal pseudophakia

Abstract

To report uncorrected distance and near visual acuity in pediatric eyes treated with primary monofocal intraocular lens (IOL) implantation. Boston Children's Hospital, Boston, Massachusetts, USA. Retrospective chart review. Records of children older than 5 years who had uneventful monofocal IOL implantation targeted for emmetropia within ± 1.00 diopter (D) spherical equivalent were reviewed. Eyes with secondary IOL placement and sulcus-fixated IOLs were excluded. Vision was tested using the Mentor BVAT or M&S system for distance and the standard Jaeger near card for near visual acuity. Keratometry, axial length, type of IOL, and preoperative and postoperative refractions were recorded. The main outcome measure was uncorrected visual acuity at distance and near. Good visual acuity was defined as 20/40 or better. Forty-one eyes of 25 children had uncorrected distance and near visual acuity recorded in the early postoperative period. The mean age was 11.2 years ± 3.6 (SD). Twenty eyes (49%) had good visual acuity at distance and near, 11 had good visual acuity at distance only, 6 had good visual acuity at near only, and 4 had worse than 20/40 at distance and near. Thirty eyes (70%) had with-the-rule astigmatism. All but 2 eyes (95%) had 20/70 or better uncorrected acuity at distance and near. In children with bilateral pseudophakia, 12 (75%) of 16 had 20/40 or better uncorrected acuity at distance and near. Monofocal IOL placement resulted in good uncorrected distance and near visual acuity in almost 50% of pediatric eyes and in 75% of patients when targeted within ± 1.00 D of emmetropia.