Phakic anterior chamber intraocular lens (Verisyse™) implantation in children for treatment of severe ansiometropia myopia and amblyopia: Six-month pilot clincial trial and review of literature
Identifieur interne : 004118 ( Main/Curation ); précédent : 004117; suivant : 004119Phakic anterior chamber intraocular lens (Verisyse™) implantation in children for treatment of severe ansiometropia myopia and amblyopia: Six-month pilot clincial trial and review of literature
Auteurs : Amir Pirouzian [États-Unis] ; Kenneth C. Ip [États-Unis] ; Henry S. O Alloran [États-Unis]Source :
- Clinical ophthalmology (Auckland, N.Z.) [ 1177-5467 ] ; 2009.
Abstract
The current study aims to evaluate both safety and efficacy of Verisyse™ (AMO, Irvine, CA) phakic anterior chamber intraocular lens (IOL) in the reduction of clinically significant (>−8 D) myopic anisometropia in children who are noncompliant to traditional medical treatment including spectacle correction or contact lenses.
Retrospective interventional case series.
Six anisometropic myopic pediatric patients in one practice were identified through chart-review. None of the patients were compliant with specatacle correction or contact lens wear and as a result had dense amblyopia of less than 20/400 by Snellen or Allen visual acuity (mean <20/400). All patients underwent Verisyse™ phakic IOL implantation in the more myopic eye by one surgeon (AP). Pre- and post-operative visual acuity, anterior/posterior segment examination, stereoacuity, axial biometry measurements, cycloplegic refraction, and endothelial cell counts were performed in all patients whenever feasible.
The age of patients ranged from 5–11 years. The mean post-operative follow-up time was six months from the time of IOL insertion. Improvement in visual acuity >6 lines was achieved in four patients (mean visual acuity of 20/70 at six months). Improvement in stereoacuity was noted in all six patients (from total mean zero seconds-arc to six-months post-operative mean of 500 seconds-arc by randot stereoacuity testing). Improvement of >2 lines of visual acuity lines was achieved in the other two patients. No patient lost any lines of visual acuity. Enhanced physical activity, coordination, and improved social interaction were noted in patients and were reported by the parents. No intra/post-operative complications were noted.
Irreversible or intractable amblyopia secondary to severe anisometropic myopia is a serious medical concern in the pediatric population. Failure of compliance with contact lens therapy consistently leads to visual loss. Anterior chamber phakic IOLs may provide a safe alternative in treatment of noncompliant anisometropic myopic patients who do not accept spectacle wear or contact lens therapy.
To reduce or eliminate highly significant anisometropic myopia in children who are noncompliant with traditional medical treatment, phakic anterior chamber IOL implantation may be considered as an alternative modality of treatment.
Url:
PubMed: 19668592
PubMed Central: 2709036
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PMC:2709036Le document en format XML
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) implantation in children for treatment of severe ansiometropia myopia and amblyopia: Six-month pilot clincial trial and review of literature</title>
<author><name sortKey="Pirouzian, Amir" sort="Pirouzian, Amir" uniqKey="Pirouzian A" first="Amir" last="Pirouzian">Amir Pirouzian</name>
<affiliation wicri:level="2"><nlm:aff id="af1-opth-3-367">The Permanente Medical Group, Santa Clara, CA, USA;</nlm:aff>
<country xml:lang="fr">États-Unis</country>
<wicri:regionArea>The Permanente Medical Group, Santa Clara, CA</wicri:regionArea>
<placeName><region type="state">Californie</region>
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<affiliation wicri:level="2"><nlm:aff id="af3-opth-3-367">Rady’s Children’s Hospital of San Diego, San Diego, CA, USA</nlm:aff>
<country xml:lang="fr">États-Unis</country>
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<author><name sortKey="Ip, Kenneth C" sort="Ip, Kenneth C" uniqKey="Ip K" first="Kenneth C" last="Ip">Kenneth C. Ip</name>
<affiliation wicri:level="2"><nlm:aff id="af2-opth-3-367">The Permanente Medical Group, San Francisco, CA, USA;</nlm:aff>
<country xml:lang="fr">États-Unis</country>
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<author><name sortKey="O Alloran, Henry S" sort="O Alloran, Henry S" uniqKey="O Alloran H" first="Henry S" last="O Alloran">Henry S. O Alloran</name>
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<sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Phakic anterior chamber intraocular lens (Verisyse<sup>™</sup>
) implantation in children for treatment of severe ansiometropia myopia and amblyopia: Six-month pilot clincial trial and review of literature</title>
<author><name sortKey="Pirouzian, Amir" sort="Pirouzian, Amir" uniqKey="Pirouzian A" first="Amir" last="Pirouzian">Amir Pirouzian</name>
<affiliation wicri:level="2"><nlm:aff id="af1-opth-3-367">The Permanente Medical Group, Santa Clara, CA, USA;</nlm:aff>
<country xml:lang="fr">États-Unis</country>
<wicri:regionArea>The Permanente Medical Group, Santa Clara, CA</wicri:regionArea>
<placeName><region type="state">Californie</region>
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<affiliation wicri:level="2"><nlm:aff id="af3-opth-3-367">Rady’s Children’s Hospital of San Diego, San Diego, CA, USA</nlm:aff>
<country xml:lang="fr">États-Unis</country>
<wicri:regionArea>Rady’s Children’s Hospital of San Diego, San Diego, CA</wicri:regionArea>
<placeName><region type="state">Californie</region>
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<author><name sortKey="Ip, Kenneth C" sort="Ip, Kenneth C" uniqKey="Ip K" first="Kenneth C" last="Ip">Kenneth C. Ip</name>
<affiliation wicri:level="2"><nlm:aff id="af2-opth-3-367">The Permanente Medical Group, San Francisco, CA, USA;</nlm:aff>
<country xml:lang="fr">États-Unis</country>
<wicri:regionArea>The Permanente Medical Group, San Francisco, CA</wicri:regionArea>
<placeName><region type="state">Californie</region>
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<author><name sortKey="O Alloran, Henry S" sort="O Alloran, Henry S" uniqKey="O Alloran H" first="Henry S" last="O Alloran">Henry S. O Alloran</name>
<affiliation wicri:level="2"><nlm:aff id="af3-opth-3-367">Rady’s Children’s Hospital of San Diego, San Diego, CA, USA</nlm:aff>
<country xml:lang="fr">États-Unis</country>
<wicri:regionArea>Rady’s Children’s Hospital of San Diego, San Diego, CA</wicri:regionArea>
<placeName><region type="state">Californie</region>
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<series><title level="j">Clinical ophthalmology (Auckland, N.Z.)</title>
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<front><div type="abstract" xml:lang="en"><sec><title>Purpose:</title>
<p>The current study aims to evaluate both safety and efficacy of Verisyse<sup>™</sup>
(AMO, Irvine, CA) phakic anterior chamber intraocular lens (IOL) in the reduction of clinically significant (>−8 D) myopic anisometropia in children who are noncompliant to traditional medical treatment including spectacle correction or contact lenses.</p>
</sec>
<sec><title>Design:</title>
<p>Retrospective interventional case series.</p>
</sec>
<sec><title>Methods:</title>
<p>Six anisometropic myopic pediatric patients in one practice were identified through chart-review. None of the patients were compliant with specatacle correction or contact lens wear and as a result had dense amblyopia of less than 20/400 by Snellen or Allen visual acuity (mean <20/400). All patients underwent Verisyse<sup>™</sup>
phakic IOL implantation in the more myopic eye by one surgeon (AP). Pre- and post-operative visual acuity, anterior/posterior segment examination, stereoacuity, axial biometry measurements, cycloplegic refraction, and endothelial cell counts were performed in all patients whenever feasible.</p>
</sec>
<sec><title>Results:</title>
<p>The age of patients ranged from 5–11 years. The mean post-operative follow-up time was six months from the time of IOL insertion. Improvement in visual acuity >6 lines was achieved in four patients (mean visual acuity of 20/70 at six months). Improvement in stereoacuity was noted in all six patients (from total mean zero seconds-arc to six-months post-operative mean of 500 seconds-arc by randot stereoacuity testing). Improvement of >2 lines of visual acuity lines was achieved in the other two patients. No patient lost any lines of visual acuity. Enhanced physical activity, coordination, and improved social interaction were noted in patients and were reported by the parents. No intra/post-operative complications were noted.</p>
</sec>
<sec><title>Discussion:</title>
<p>Irreversible or intractable amblyopia secondary to severe anisometropic myopia is a serious medical concern in the pediatric population. Failure of compliance with contact lens therapy consistently leads to visual loss. Anterior chamber phakic IOLs may provide a safe alternative in treatment of noncompliant anisometropic myopic patients who do not accept spectacle wear or contact lens therapy.</p>
</sec>
<sec><title>Conclusion:</title>
<p>To reduce or eliminate highly significant anisometropic myopia in children who are noncompliant with traditional medical treatment, phakic anterior chamber IOL implantation may be considered as an alternative modality of treatment.</p>
</sec>
</div>
</front>
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