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Management of pseudophakic myopic anisometropic amblyopia with piggyback Visian ® implantable collamer lens
Author(s) -
Eissa Sherif A.
Publication year - 2017
Publication title -
acta ophthalmologica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.534
H-Index - 87
eISSN - 1755-3768
pISSN - 1755-375X
DOI - 10.1111/aos.13203
Subject(s) - medicine , scheimpflug principle , ophthalmology , intraocular lens , anisometropia , phacoemulsification , astigmatism , refractive error , visual acuity , optometry , cornea , optics , physics
Purpose To assess the outcomes of sulcus implantation of the Visian ® implantable collamer lens ( ICL ) to correct pseudophakic myopic anisometropic amblyopia with myopic shift and/or primary refractive overcorrection. Methods Prospective case series enrolled 14 pseudophakic eyes of 14 patients, 5–9 years old, with history of cataract surgery and primary in the bag‐intraocular lenses ( IOL ) implantation, followed by myopic shift and/or refractive overcorrection and anisometropic amblyopia of variable degrees. All cases had implantation of a piggyback ICL /toric ICL, to correct the myopia/myopic astigmatism. Preoperatively, we evaluated the uncorrected distance visual acuity (UCVA), corrected distance visual acuity ( CDVA ), manifest refraction spherical equivalent ( MRSE ), intraocular pressure ( IOP ) and endothelial cell density ( ECD ). We assessed the position and vaulting of the ICL s on slit lamp examination and confirmed by Scheimpflug tomography. Postoperative follow‐up was at 1st week and 1, 3, 6, 9, 12, 18 and 24 months. Results Uncorrected distance visual acuity improved in all cases, and CDVA improved in 11 amblyopic eyes (2–4 lines). There was no evidence of interlenticular opacification ( ILO ) throughout the 2‐year follow‐up. Two cases were complicated with early postoperative acute elevation of IOP and were controlled with topical beta‐blockers. Postoperative acute anterior uveitis occurred in six eyes and controlled by topical steroids. Implantable collamer lens (ICL) vault was measured using Pentacam, with mean value of 470 ± 238 μ m. Conclusion Sulcus implantation of the secondary piggyback ICL to correct unilateral pseudophakic myopic refractive error in children was safe, efficient, predictable and well tolerated in management of anisometropic amblyopia in all eyes.