title: Posterior chamber toric phakic IOL implantation for the management of pediatric anisometropic amblyopia.
abstract: OBJECTIVE
  To report the outcomes of toric posterior chamber phakic intraocular lens (PIOL) implantation in children for the treatment of amblyopia due to anisometropia with astigmatism.
  
  
  METHODS
  Six eyes of 6 amblyopic patients aged 5 to 15 years underwent toric PIOL (Visian Toric ICL; STAAR Surgical Company, Monrovia, CA) implantation for refractory anisometropic amblyopia. Preoperative and postoperative clinical evaluation included slit-lamp microscopy, visual acuity, anterior/posterior segment examination, and cycloplegic refraction.
  
  
  RESULTS
  After a mean follow-up of 23 months (range: 15 to 34 months), mean spherical equivalent cycloplegic refraction improved from -10.21 ± 4.62 diopters (D) (range -7.5 to -19.5 D) preoperatively to -0.42 ± 0.39 D (range: -0.625 to +0.125 D) postoperatively. Corrected distance visual acuity ranged from 20/40 to 20/200 preoperatively and 20/20 to 20/60 postoperatively. Five of the 6 eyes gained more than 3 lines of corrected distance visual acuity with a maximum gain of 8 lines in one eye. One eye showed an improvement of more than 2 lines (change in preoperative visual acuity of 20/100 to 20/60 postoperatively). No patients lost any lines of visual acuity. All eyes remained quiet. All PIOLs remained well centered throughout the follow-up period.
  
  
  CONCLUSIONS
  Toric PIOL implantation may be a viable therapeutic modality in children with clinically significant anisometropic ametropia and astigmatism with secondary amblyopia who have been refractory to medical treatment including spectacles or contact lenses. Longer follow-up visits with larger sample populations will evaluate more effectively the long-term efficacy and late-onset of complications.
authors.affiliation: Taif University, Taif, Saudi Arabia. tthomali@hotmail.com
authors.forename: Talal Abdulrahman
authors.initials: TA
authors.lastname: Althomali
mesh_terms: D000293:Adolescent; D000550:Amblyopia / Q000503:physiopathology / Q000601:surgery*; D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D054120:Phakic Intraocular Lenses; D012029:Refraction, Ocular; D012189:Retrospective Studies; D016896:Treatment Outcome; D014792:Visual Acuity