Visual outcomes after toric intraocular lens implantation in pediatric eyes undergoing cataract surgery

Purpose: To evaluate long-term visual outcomes and complications after toric intraocular lens (IOL) implantation in children with preexisting corneal astigmatism undergoing cataract surgery. Setting: Iladevi Cataract & IOL Research Center, Ahmedabad, India. Design: Prospective, interventional case series. Methods: Children with regular corneal astigmatism of at least 1.5 diopters (D) were included. A standardized surgical technique with in-the-bag implantation of a toric IOL was performed. All children were followed up on postoperative day 1 and periodically thereafter, until 36 months postoperatively. The uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), and residual refractive astigmatism were documented 36 months postoperatively. Rotational stability of toric IOL was also evaluated through the follow-up duration. Complications, particularly visual axis obscuration (VAO) and glaucoma, were documented. Results: In total, 76 eyes (51 children) were included in the study. Mean age at surgery was 7.41 +/- 2.82 years (SD) and mean preoperative keratometric astigmatism was 1.56 +/- 2.13 D. The CDVA (logarithm of the minimum angle of resolution ElogMARD improved significantly from 0.59 +/- 0.43 preoperatively to 0.23 +/- 0.27 36 months postoperatively (P = .03). Mean postoperative UDVA was 0.32 +/- 026 logMAR. Mean refractive astigmatism at final follow-up was 0.55 +/- 0.40 D, with 74% patients having a UDVA of at least 20/40; 5% of eyes needed VAO treatment and none developed glaucoma No eye required repositioning of toric IOL until final follow-up. Conclusions: Tonc IOL implantation reduced postoperative refractive astigmatism and gave excellent UDVA at 36 months follow-up in pediatric eyes undergoing nontraumatic cataract surgery. Copyright (C) 2020 Published by Wolters Kluwer on behalf of ASCRS and ESCRS