Journal of cataract and refractive surgery | 2021
Comparative analysis of visual outcomes of multifocal and monofocal intraocular lenses in congenital cataract surgery.
Abstract
PURPOSE\nTo assess the impact on visual development of multifocal versus monofocal intraocular lenses (IOLs) implantation in children following congenital cataract surgery.\n\n\nDESIGN\nRetrospective interventional consecutive case series.\n\n\nMETHODS\nWe reviewed the records of 56 eyes of 43 pediatric patients who underwent congenital cataract surgery with phacoaspiration and simultaneous implantation of IOL under one year of age. Corrected distance visual acuity (CDVA), refractive error and ocular motility disorders were evaluated after a follow-up greater than 4 years.\n\n\nRESULTS\nWe implanted 32 multifocal (18unilateral, Group A and 14bilateral, Group B) and 24monofocal IOLs (12unilateral, Group C and 12bilateral, Group D). Mean follow-up was 6.67 years. Mean CDVA of the eyes with multifocal IOL was 0.75±0.46 logMAR in unilateral cataract surgery and 0.34±0.25logMAR in bilateral ones; with monofocal IOLs was 0.71±0.52logMAR in unilateral and 0.53±0.43logMAR in bilateral ones. No statistically significant difference in CDVA between Groups A and B and Groups C and D has been recorded. Final mean spherical equivalent was -3.88±4.73D; in Group A it was -2.74±4.22D, in Group C was -1.08±1.45D, in Group B was -4.82±4.64D and in Group D was -6.81 ± 4.61D.The difference was statistically significant between Group B and D (p=0.01), but not between Group A and C (p=0.14).Twenty-six patients (60.4%) showed post-operative strabismus. Its surgical correction occurred more in patients with multifocal IOL implanted (p=0.038).\n\n\nCONCLUSIONS\nOur findings suggest that the use of multifocal IOLs did not show significant advantages in visual development in children following congenital cataract extraction under one year of age if compared with monofocal IOLs.