Pediatric Intraocular Lenses in Cataract Surgery

Sevil KARAMAN ERDURa , Bengi DEMİRAYAKb

aİstanbul Medipol University Faculty of Medicine, Department of Ophthalmology, İstanbul, Türkiye
bUniversity of Health Sciences Faculty of Medicine, İstanbul Bakırköy Sadi Konuk Training and Research Hospital, Department of Ophthalmology, İstanbul, Türkiye

ABSTRACT
This comprehensive article delves into the multifaceted world of pediatric cataract surgery, highlighting the challenges and critical factors that shape the outcomes for these young patients. Pediatric cataracts, though relatively rare, have a significant impact on childhood blindness. The article underscores the unique considerations in pediatric cases, such as the need for sharp near vision, challenges in managing astigmatism, and the importance of timely intervention to prevent amblyopia. Secondary intraocular lens (IOL) implantation emerges as a valuable option for children intolerant to aphakic correction, with a careful assessment of design and age-related concerns. The choice of IOL implantation site, influenced by capsular support, is pivotal. While premium lenses remain a less-explored territory in pediatric cases due to limited research, monofocal IOLs remain a standard choice, given their well-established safety and refractive outcomes. In summary, this article emphasizes the complexities of pediatric cataract surgery and the need for a tailored approach, considering age, astigmatism, IOL type, and amblyopia management, all aimed at enhancing the visual outcomes and quality of life for these young patients.
Keywords: Amblyopia; multifocal intraocular lenses; aphakia, congenital primary; pediatric cataract surgery; lenses, intraocular; phacoemulsification; cataract congenital dominant non nuclear

Referanslar

  1. Foster A, Gilbert C, Rahi J. Epidemiology of cataract in childhood: a global perspective. J Cataract Refract Surg. 1997;23 Suppl1:601-4. [Crossref]  [PubMed]
  2. Mohammadpour M, Shaabani A, Sahraian A, Momenaei B, Tayebi F, Bayat R, et al. Updates on managements of pediatric cataract. J Curr Ophthalmol. 2018;31(2):118-26. [Crossref]  [PubMed]  [PMC]
  3. Indaram M, VanderVeen DK. Postoperative refractive errors following pediatric cataract extraction with intraocular Lens implantation. Semin Ophthalmol. 2018;33 (1):51-8. [Crossref]  [PubMed]
  4. Ram J, Agarwal A, Kumar J, Gupta A. Bilateral implantation of multifocal versus monofocal intraocular lens in children above 5 years of age. Graefes Arch Clin Exp Ophthalmol. 2014;252(3):441-7. [Crossref]  [PubMed]
  5. Bar-Sela SM, Barequet IS, Spierer A. Vector analysis of high early postoperative astigmatism after congenital cataract surgery. Graefes Arch Clin Exp Ophthalmol Albrecht Von Graefes Arch Klin Exp Ophthalmol. 2005;243(9): 881-5. [Crossref]  [PubMed]
  6. Trivedi RH, Wilson Jr ME, Facciani J. Secondary intraocular lens implantation for paediatric aphakia. JAAPOS. 2005;9(4):346-52. [Crossref]  [PubMed]
  7. Zhao YE, Gong XH, Zhu XN, Li HM, Tu MJ, Coursey TG, et al. Long- term outcomes of ciliary sulcus versus capsular bag fixation of intraocular lenses in children: an ultrasound bio-microscopy study. PloS one. 2017;12(3): e0172979. [Crossref]  [PubMed]  [PMC]
  8. Serafino M, Trivedi RH, Levin AV, Wilson ME, Nucci P, Lambert SR, et al. Use of the Delphi process in paediatric cataract management. Br J Ophthalmol. 2016;100(5):611-5. [Crossref]  [PubMed]
  9. Shenoy BH, Mittal V, Gupta A, Sachdeva V, Kekunnaya R. Refractive outcomes and prediction error following secondary intraocular lens implantation in children: a decade- long analysis. Br J Ophthalmol. 2013;97(12):1516-9. [Crossref]  [PubMed]
  10. Wood KS, Tadros D, Trivedi RH, Wilson ME. Secondary intraocular lens implantation following infantile cataract surgery: intraoperative indications, postoperative outcomes. Eye. 2016;30(9):1182-6. [Crossref]  [PubMed]  [PMC]
  11. Rychwalski PJ. Multifocal IOL implantation in children: is the future clear? J Cataract Refract Surg. 2010;36(12):2019-21. [Crossref]  [PubMed]
  12. Braga-Mele R, Chang D, Dewey S, Foster G, Henderson BA, Hill W, et al. Multifocal intraocular lenses: relative indications and contraindications for implantation. J Cataract Refract Surg. 2014;40(2):313-22. [Crossref]  [PubMed]
  13. Wilson ME, Trivedi RH, Burger BM. Eye growth in the second decade of life: implications for the implantation of a multifocal intraocular lens. Trans Am Ophthalmol Soc. 2009;107:120-4.
  14. Enyedi LB, Peterseim MW, Freedman SF, Buckley EG. Refractive changes after pediatric intraocular lens implantation. Am J Ophthalmol. 1998;126(6):772-81. [Crossref]  [PubMed]
  15. Trivedi RH, Wilson ME, Bandyopadhyay D. Refractive shift in pseudophakic eyes during the second decade of life. J Cataract Refract Surg. 2012;38(1): 102-7. [Crossref]  [PubMed]
  16. Fledelius HC. Ophthalmic changes from age of 10 to 18 years. A longitudinal study of sequels to low birth weight. IV. Ultrasound oculometry of vitreous and axial length. Acta Ophthalmol (Copenh). 1982;60(3):403-11. [Crossref]  [PubMed]
  17. Leat SJ, Yadav NK, Irving EL. Development of visual acuity and contrast sensitivity in children. J Optom. 2009;2(1):19-26. [Crossref]
  18. Cristóbal JA, Remón L, Del Buey MÁ, Montés-Micó R. Multifocal intraocular lenses for unilateral cataract in children. J Cataract Refract Surg. 2010;36(12):2035-40. [Crossref]  [PubMed]
  19. Dénier C, Dureau P, Edelson C, Barjol A, Caputo G. Pseudo-accommodation in non-amblyopic children after bilateral cataract surgery and implantation with a monofocal intraocular lens: prevalence and possible mechanisms. Graefes Arch Clin Exp Ophthalmol. 2017;255(2):407-12. [Crossref]  [PubMed]
  20. Jacobi PC, Dietlein TS, Konen W. Multifocal intraocular lens implantation in pediatric cataract surgery. Ophthalmology. 2001;108(8):1375-80. [Crossref]  [PubMed]
  21. Abouzeid H, Moetteli L, Munier FL. New-generation multifocal intraocular lens for pediatric cataract. Ophthalmologica. 2013;230(2):100-7. [Crossref]  [PubMed]
  22. Huang Y, Dong X, Zhang J, Wan X, Wang M, Xie L. Full-Diffractive Multifocal Intraocular Lens Posterior Optic Capture for Selected Pediatric Cataracts. J Refract Surg. 2021;37(6):390-7. [Crossref]  [PubMed]
  23. Tytla ME, Lewis TL, Maurer D, Brent HP. Stereopsis after congenital cataract. Invest Ophthalmol Vis Sci. 1993;34(5):1767-73.
  24. Gray PJ, Lyall MG. Diffractive multifocal intraocular lens implants for unilateral cataracts in prepresbyopic patients. Br J Ophthalmol. 1992;76(6):336-7. [Crossref]  [PubMed]  [PMC]
  25. Lin HY, Wang CE, Lin SY, Hsu HK. The surgical outcome and personality change in a child with congenital cataract after multifocal intraocular lens implantation. Eye Lond Engl. 2010;24(6):1107. [Crossref]  [PubMed]
  26. Gwiazda J, Scheiman M, Mohindra I, Held R. Astigmatism in children: changes in axis and amount from birth to six years. Invest Ophthalmol Vis Sci. 1984;25(1):88-92.
  27. Ram J, Singh R, Gupta R, Bhutani G, Gupta PC, Sukhija J. Toric intraocular lens implantation in children with developmental cataract and preexisting corneal astigmatism. Acta Ophthalmol (Copenh). 2017;95(2):e95-100. [Crossref]
  28. Vasavada V, Shastri L, Vasavada AR, Patel P, Agarwal D, Vasavada SA, et al. Visual outcomes after toric intraocular lens implantation in pediatric eyes undergoing cataract surgery. J Cataract Refract Surg. 2020;46(8):1102-7. [Crossref]  [PubMed]
  29. Tachibana K, Maeda N, Abe K, Kusaka S. Efficacy of toric intraocular lens and prevention of axis misalignment by optic capture in pediatric cataract surgery. J Cataract Refract Surg. 2021;47(11):1417-22. [Crossref]  [PubMed]
  30. Zeng Y, Fan L, Lu P. Multifocal toric intraocular Lens for traumatic cataract in a child. Case Rep Ophthalmol. 2016;7(3):481-7. [Crossref]  [PubMed]  [PMC]
  31. Vianna LMM, Prescott CR, Ferraz LO. Trifocal toric intra-ocular lens implantation in pediatric traumatic cataract. Am J Ophthalmol Case Rep. 2020;17:100575. [Crossref]  [PubMed]  [PMC]
  32. Siddiqui SN, Khan A. Visual outcome and changes in corneal endothelial cell density following aphakic iris-fixated intraocular lens implantation in paediatric eyes with subluxated lenses. JAAPOS. 2013;50(3):178-82. [Crossref]  [PubMed]
  33. Sminia ML, Odenthal MT, Prick LJ, Mourits MP, Völker-Dieben HJ. Long-term follow-up of the corneal endothelium after aphakic iris-fixated IOL implantation for bilateral cataract in children. J Cataract Refract Surg. 2011;37(5):866-72. [Crossref]  [PubMed]
  34. Brandner M, Thaler-Saliba S, Plainer S, Vidic B, El-Shabrawi Y, Ardjomand N. Retropupillary fixation of iris-claw intraocular lens for aphakic eyes in children. PLoS One. 2015;10(6):e0126614. [Crossref]  [PubMed]  [PMC]
  35. Gonnermann J, Amiri S, Klamann M, Maier AK, Joussen AM, Rieck PW, et al. Endothelial cell loss after retropupillary iris-claw intraocular lens implantation. Klinische Monatsbl. 2014;231(8):784-7. [Crossref]  [PubMed]
  36. Cleary C, Lanigan B, O'Keeffe M. Artisan iris-claw lenses for the correction of aphakia in children following lensectomy for ectopia lentis. Br J Ophthalmol. 2012;96(3):419-21. [Crossref]  [PubMed]
  37. Kumar M, Arora R, Sanga L, Sota LD. Scleral-fixated intraocular lens implantation in unilateral aphakic children. Ophthalmology. 1999;106(11):2184-9. [Crossref]  [PubMed]
  38. Kumar DA, Agarwal A, Agarwal A, Prakash G, Jacob S. Glued intraocular lens implantation for eyes with defective capsules: a retrospective analysis of anatomical and functional outcome. Saudi J Ophthalmol. 2011;25(3):245-54. [Crossref]  [PubMed]  [PMC]
  39. Turner RP, Owen L, Davidson J, Trivedi R, Wilson ME. Long-term outcomes of anterior chamber intraocular lens placement in a paediatric cohort. Pediatric Transplantation. 2015;19(4):e66. JAAPOS. [Crossref]
  40. Epley KD, Shainberg MJ, Lueder GT, Tychsen L. Paediatric secondary lens implantation in the absence of capsular support. JAAPOS. 2001;5(5):301-6. [Crossref]  [PubMed]