Multifocal and toric implantation in a paediatric population: a retrospective study

Abstract

Purpose The management of pediatric cataract is a therapeutic challenge. The aim of our study was to assess the potential benefits of the multifocal and toric lens implantation in the children depending on the age. The previous results of multifocal IOL in the child are encouraging but are derived from analyzes of children over 4 years. The toric implantation in the childhood was never studied. Methods In this retrospective non‐randomized monocentric study, children with bilateral and unilateral cataract between 0 and 9 years with a visual acuity less than 0,3logMAR were implanted with multifocal IOL (or with a toric IOL when the corneal astigmatism was higher than 2 dioptries). Outcome measures of best corrected visual acuity (BCVA) for distance, distance‐corrected near visual acuity (DCNVA), contrast sensitivity, stereopsis and total astigmatism were analysed with the Student test in 2 age groups : less than 4 years (group 1) and more than 4 years (group 2). Results 21 eyes of 16 children (mean age 5,05 years, from 9 months to 9 years) were included in the multifocal study, 3 eyes of 2 children were included in the toric study. Group 1 included 5 eyes (4 children), group 2 included 13 eyes (10 children). Both groups showed significant improvement in BCVA at one year follow‐up. Stereopsis was better in group 2 with unilateral implantation. The improvement of the DCNVA was significantly better in group 2 with unilateral implantation (0,38 logMAR, p<0,05). The total astigmatism, the BCVA and DCNVA were improved with a toric implantation, the stereopsis was similar. Conclusion Multifocal IOL implantation is a viable option for the children more than four years with unilateral cataract. The toric implantation analysis needs further results.