Multifocal intraocular lens implantation in pediatric cataract surgery.
OBJECTIVE
To evaluate implantation of a zonal-progressive multifocal intraocular lens (IOL) in children.


METHODS
Prospective, noncomparative, interventional case series.


METHODS
Thirty-five eyes of 26 pediatric patients aged 2 to 14 years with multifocal IOL implantation at one institution with more than 1 year of follow-up.


METHODS
Standard surgical procedure comprised an anterior capsulorrhexis, lens material aspiration via two side-port incisions, temporal tunnel incision, and multifocal IOL (SA40-N; Allergan, Irvine, CA) implantation in all eyes. In 24 eyes (68%), a 5-mm posterior capsulorrhexis was created with forceps, followed by an anterior vitrectomy in 19 of those eyes (54%).


RESULTS
Twenty-six patients (35 eyes) had an average follow-up of 27.4 +/- 12.7 months (range, 12-58 months). At last follow-up, best-corrected distance visual acuity improved significantly (P = 0.001), 71% of eyes with a visual acuity of 20/40 or better and 31% of eyes with a visual acuity of 20/25 or better. In the 9 bilateral cases, spectacle dependency was moderate, with only 2 children (22%) reporting the permanent use of an additional near correction. The remaining children were either using distance-correction only (4 patients; 44%) or no glasses at all (3 patients; 33%). Stereopsis also improved significantly after multifocal IOL implantation (P = 0.01). Sixteen eyes (46%) experienced obscuration of the entrance pupil that required intervention, with 10 requiring a second intraocular surgery. Four eyes required an anterior membranectomy for persistent fibrinous membrane. Intraocular lens decentration requiring surgical intervention developed in six eyes.


CONCLUSIONS
Multifocal IOL implantation is a viable alternative to monofocal pseudophakia in this age group.
Jacobi
P C
PC
Department of Ophthalmology, University of Cologne, Cologne, Germany. Philipp.Jacobi@uni-koeln.de
Dietlein
T S
TS
Konen
W
W
D000293:Adolescent; D019923:Capsulorhexis / Q000379:methods*; D002386:Cataract / Q000150:complications / Q000628:therapy; D002648:Child; D002675:Child, Preschool; D003867:Depth Perception / Q000502:physiology; D005139:Eyeglasses; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D019654:Lens Implantation, Intraocular / Q000379:methods*; D007910:Lenses, Intraocular; D008297:Male; D011183:Postoperative Complications; D011446:Prospective Studies; D012449:Safety; D016896:Treatment Outcome; D014792:Visual Acuity / Q000502:physiology