Verisyse intraocular lens implantation in a child with anisometropic amblyopia: Four-year follow-up

Abstract

A Verisyse phakic intraocular lens (pIOL) (AMO) was implanted in the eye of a 3-year-old child with unilateral high myopia and suspected dense amblyopia. Four years postoperatively, the Snellen visual acuity was 20/30 with a refraction of -1.00 -1.00 x 77 and the endothelial cell density was 3262 cells/mm(2) compared with 3092 cells/mm(2) in the right eye. The Verisyse pIOL may be a treatment option to prevent dense amblyopia in children with highly myopic anisometropia.

Refractive Surgery for Special Needs Children

“…The major concern with use of any phakic IOL in a child is the long-term effect on the corneal endothelium. Experience to date indicates that endothelial cell loss is low, 8,26,27,31 no greater than that reported in adult implantation. However, the data here are thin.…”

“…Obtaining the preoperative quantitative information needed often requires multiple sets of measurements by examiners skilled in examining uncooperative children, supplemented by a confirmatory set obtained during a brief examination under anesthesia. 6,9 The surgical devices and techniques used, progressing from least to most invasive, are advanced surface ablation (ASA) using the excimer laser (ie, photorefractive keratectomy) 6,8,15,[19][20][21][22][23][24][25] ; implantation of a phakic intraocular lens (IOL) 9,[26][27][28][29][30][31] ; and clear lens extraction (CLE) with or without insertion of a posterior chamber IOL (refractive lens exchange [RLE] 7,10 ). The following is a general strategy.…”

Pediatric refractive surgery: Corneal and intraocular techniques and beyond

“…The implant 30 we prefer and that is used most in several reports from other investigators [39][40][41] is the anterior chamber Artisan iris-enclaved IOL. [42][43][44] As mentioned previously, the myopic Verisyse lens in the United States is the same lens as the Artisan lens marketed in Europe and Asia.…”

“…Experience to date indicates that endothelial cell loss is low, no greater than that reported in adult implantation. 26,29,30,[39][40][41]46,47,49 The data here, however, are meager and accurate endothelial cell counts are difficult to obtain in the children who may benefit most from implantation. 30 It is important to note that any refractive surgical procedure, including ASA, phakic IOL, or refractive lens exchange, can be expected to cause some reduction of endothelial cell density.…”

Posterior sclera reinforcement and phakic intraocular lens implantation for highly myopic amblyopia in children: a 3-year follow-up

“…Phakic intraocular lens (PIOLs) implantation for children has been reported in the literature. [3][4][5][6][7] In the current study, posterior scleral reinforcement surgery (PSR) and PIOL implantation were performed in highly myopic amblyopic children. The safety and efficacy for 3 years of follow-up were analyzed.…”