Bilateral implantation of multifocal versus monofocal intraocular lens in children above 5 years of age.
OBJECTIVE
To evaluate visual results and complications after bilateral implantation of multifocal versus monofocal intraocular lens (IOL) in children above five years of age.


METHODS
In this prospective non-randomized controlled trial, children with bilateral developmental cataract above five years of age were divided into two groups - Group A implanted with multifocal IOL (both refractive and diffractive) and Group B implanted with monofocal IOL in both eyes. Outcome measures of best corrected visual acuity (BCVA) for distance, distance-corrected near visual acuity (DCNVA), mean refractive spherical equivalent (MRSE), contrast sensitivity, stereopsis and complications such as posterior capsular opacification (PCO) and glare were analyzed using the Mann-Whitney U and the Wilcoxon Signed Rank tests.


RESULTS
Forty-two eyes of 21 children (mean age: 7.19 years, range: 5-12 years) were included in the study. Group A included 14 eyes (seven children) Group B included 28 eyes (14 children). Both groups showed significant improvement in BCVA at one year follow-up, but no significant difference was found on comparing contrast sensitivity. Stereopsis was slightly better in Group A (125.71 arc-sec) as compared to Group B (140 arc-sec) (p = 0.280). Most patients in Group A were spectacle-independent for near (71.4 %) versus Group B. MRSE at one year was 0.21 in Group A and 0.5 in Group B. Incidence of PCO was similar in either groups (35.7 %). No intraoperative complication was noted in any child.


CONCLUSIONS
Multifocal IOL implantation is a viable option in children above five years of age with bilateral cataract.
Department of Ophthalmology, Advanced Eye Centre, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, 160012, India, drjagatram@gmail.com.
Jagat
J
Ram
Aniruddha
A
Agarwal
Jaidrath
J
Kumar
Adit
A
Gupta
D002386:Cataract / Q000151:congenital*; D002648:Child; D002675:Child, Preschool; D015350:Contrast Sensitivity / Q000502:physiology*; D003867:Depth Perception / Q000502:physiology*; D005260:Female; D006801:Humans; D019654:Lens Implantation, Intraocular; D007910:Lenses, Intraocular; D008297:Male; D018918:Phacoemulsification; D011183:Postoperative Complications; D011446:Prospective Studies; D011474:Prosthesis Design; D019591:Pseudophakia / Q000503:physiopathology; D016896:Treatment Outcome; D014786:Vision Disorders / Q000534:rehabilitation; D014792:Visual Acuity / Q000502:physiology*