MIOL implantation in paediatric cases

"While the presence of binocular clear media is mandatory for complete vision rehabilitation and amblyopia treatment, the choice of lens for a child is of importance as it impacts the development of their vision and has a potentially life-long effect," she continued. "Behavioural difficulties in the wearing of glasses or contact lenses are frequent in children, especially those with a syndromic cataract. The use of MIOL in children, with the advantage of correcting both distance and near vision, is thus highly attractive."

However, Dr Abouzeid noted that it can be difficult to assess the occurrence of well known side effects of MIOLs in children, such as low contrast sensitivity, presence of halos or glare, or their influence on visual development, amblyopia and its treatment outcomes. "Refractive shift with eye growth is another major issue to be considered in the choice of the best suitable lens for a child, especially in the case of MIOLs, and it is because of these factors that MIOL implantation is controversial in paediatric cases," she advised..

To evaluate the implantation of a MIOL in children Dr Abouzeid and colleagues reviewed 34 eyes of 26 patients who had all undergone surgery at the same institute and had been followed up for at least 1 year. "We reviewed the files of the operated patients and created a database with selected main criteria to study that would reflect the outcomes. We selected cases with a minimum of 12 months follow-up to appropriately study complications," Dr Abouzeid added.

The mean age of the patients was 7.87 ± 4.8 years and out of the study group there were 14 patients that underwent unilateral surgery. All patients were implanted with the same lens (Alcon, model SN6AD3, Alcon Laboratories Inc., Fort Worth, Texas, USA). "We chose this lens because of the large studies available attesting its safety and high refractive quality as well as for the fact that it carries on blue light filtration and provides +3 dioptres equivalent in glasses, which may be useful for children," she explained.

Spearman correlations were calculated for all cases between the preop visual acuity and postop stereopsis, the patient's age at surgery and postop stereopsis as well as the change in visual acuity and the age at surgery. Additionally, bilateral and unilateral implantation procedures were treated separately in these calculations.