title: Phakic intraocular lens implantation for treatment of anisometropia and amblyopia in children: 5-year follow-up.
abstract: OBJECTIVE
  To evaluate the safety and efficacy during 5-year follow-up of phakic intraocular lens (PIOL) implantation to correct high anisometropia in amblyopic children who were non-compliant with traditional medical treatment including spectacles or contact lenses.
  
  
  METHODS
  Retrospective study of 10 eyes of 10 children with high anisometropia who underwent PIOL implantation (9 with an iris-supported IOL and 1 with a posterior chamber IOL). Patient age at the time of implantation ranged from 2 to 15 years. Mean preoperative spherical equivalent refraction was -10.14 ± 6.96 diopters (D) (range: +8.00 to -18.00 D). Mean logMAR corrected distance visual acuity (CDVA) was 0.84 ± 0.52. Postoperative data at 6, 24, and 60 months were evaluated.
  
  
  RESULTS
  Corrected distance visual acuity improved in all children. At 24 months, logMAR CDVA was 0.39 ± 0.35 and at 5 years was 0.36 ± 0.38 (range for both: 0.1 to 1.0) (P=.01). Improvement of more than three logMAR lines of CDVA was achieved in all children except for one (one line improvement) who was implanted with a posterior chamber PIOL. No loss of CDVA was detected in any patient. Five years after surgery, endothelial cell count was >2000 cells/mm(2) in eight (80%) patients; for the remaining two patients, one reported frequent eye rubbing and the other suffered ocular trauma.
  
  
  CONCLUSIONS
  Phakic IOL implantation in children with anisometropic amblyopia showed a positive long-term impact on visual acuity.
authors.affiliation: Instituto Oftalmologico de Alicante, Vissum Corporation, Spain. jlalio@vissum.com
authors.forename: Jorge L
authors.initials: JL
authors.lastname: Alió
authors.forename: Bader T
authors.initials: BT
authors.lastname: Toffaha
authors.forename: Carlos
authors.initials: C
authors.lastname: Laria
authors.forename: David P
authors.initials: DP
authors.lastname: Piñero
mesh_terms: D000293:Adolescent; D000550:Amblyopia / Q000150:complications / Q000503:physiopathology / Q000601:surgery*; D015858:Anisometropia / Q000150:complications / Q000503:physiopathology / Q000601:surgery*; D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D019654:Lens Implantation, Intraocular / Q000379:methods*; D008297:Male; D054120:Phakic Intraocular Lenses; D012029:Refraction, Ocular / Q000502:physiology*; D012189:Retrospective Studies; D013997:Time Factors; D014792:Visual Acuity