A Long Term Follow Up of Posterior Chamber Phakic Intraocular Lenses for Correcting Intractable Pediatric Myopic Anisometropic Amblyopia
Abstract Background Pediatric myopic anisometropic amblyopia is one of the most challenging clinical situations that can face an ophthalmologist. Conventional correction modalities for myopic anisometropic amblyopia, using spectacles, contact lenses, and/or occlusion therapy, may not be suitable for some pediatric patients or for some ocular conditions. This may lead to the development of amblyopia and loss of binocular vision. The aim of the present study was to evaluate the visual and refractive efficacy, safety, and stability of Posterior Chamber Phakic Intraocular Lenses (PC-pIOLs) for correcting pediatric myopic anisometropic amblyopia. Methods This case series, prospective, interventional study was conducted at Watany Eye Hospital, Cairo, Egypt. It comprised 42 eyes of 42 children with myopic anisometropic amblyopia and unsuccessful conventional therapy. After implantation of Intraocular Collamer Lenses “ICLs” (Visian ICL, Model V4c, STAAR Surgical, Monrovia, California, USA), postoperative follow up visits were scheduled, with subjective refraction and Pentacam imaging performed. Results The patients’ age range was 3 to 18 years (mean ± SD = 10.58 years ± 4.23). The mean preoperative SE was − 12.54 D ± 2.93. The results declared a significant improvement in the postoperative CDVA (P value < 0.01) and SE (P value < 0.01). The efficacy index had a value of 1.18 ± 0.3 and the safety index was 1.09 ± 0.24. The follow up visits had a mean ± SD of 14.67 months ± 16.56 (range of 1 to 54 months). The results showed a refractive stability, with slight (statistically insignificant) improvements in the subjective refraction between the first postoperative and the follow up visits. No postoperative complications were encountered. Conclusions The present study, with the longest reported follow up range, declared the long-term efficacy, safety, and stability of Visian ICLs for correcting pediatric myopic anisometropic amblyopia. The reported non-compliance with occlusion therapy validates the early implantation of Visian ICLs in cases of failed conventional therapy to guard against anisometropic amblyopia.