Multifocal intraocular lenses for unilateral cataract in children

PURPOSE: To evaluate the implantation of apodized diffractive multifocal intraocular lenses (IOLs) in children with unilateral cataract. SETTING: Ophthalmology Service, Hospital Clínico Lozano Blesa, Zaragoza, Spain. DESIGN: Prospective clinical study. METHODS: Five children between 4 and 6 years of age with unilateral cataract had cataract extraction and implantation of an apodized diffractive multifocal IOL (AcrySof Restor SN60D3). Phacoaspiration was accompanied by posterior capsulorhexis followed by an anterior vitrectomy. Uncorrected distance (UDVA), corrected distance (CDVA), and corrected near (CNVA) visual acuities; binocular function using the Worth 4-dot test and the TNO stereotest; and subjective symptoms such as glare and halos were evaluated over 21 months of follow-up. RESULTS: At the final follow-up visit, the mean UDVA was 0.45 ± 0.149 logMAR and the mean CDVA was 0.30 ± 0.06 logMAR with 20/32 in 3 eyes, 20/50 in 1 eye, and 20/63 in 1 eye. The mean CNVA was 0.10 ± 0.05 logMAR (about 20/25) with J1 in 2 eyes, J2 in 1 eye, J3 in 1 eye, and J4 in 1 eye. The stereoacuity was 120 seconds of arc (arcsec) in 2 patients, 240 arcsec in 1 patient, 1980 arcsec in 1 patient, and nonexistent in 1 patient. The Worth 4-dot test showed that 4 patients had fusion. None of the 5 patients complained about halos or glare. No IOL decentration was observed in any patient. CONCLUSION: Implantation of an apodized multifocal IOL seems to be a satisfactory alternative to monofocal pseudophakia in children with unilateral cataract.