Introduction: Pediatric cataracts are unique in that surgical treatment, while visually beneficial, causes instantaneous presbyopia. Choosing an intraocular lens (IOL) poses a distinct challenge in children, including accounting for eye growth and myopic shift. Specialty IOLs such as enhanced monofocal lens (EML) implants may allow a subset of pediatric patients to achieve good visual acuity at a range of distances. Use of these lenses is well-characterized in adults, but data regarding their use in children are sparse. Patient and Clinical Findings: A retrospective case series of 6 eyes of 5 patients ranging in age from 7 to 15 years old, undergoing CE/IOL with a TECNIS Eyehance EML was performed at a single academic medical center. Diagnosis, Interventions, and Outcomes: Of the 5 patients, 4 underwent CE/IOL unilaterally, and the fifth bilaterally and sequentially. All 6 eyes showed improved distance visual acuity; 1 patient required correction of intentional myopia. 3 of 6 eyes had uncorrected near vision within 3 lines or less of their distance acuity; 1 of these eyes had uncorrected near acuity of 20/40. 4 of 5 patients achieved uncorrected stereopsis of 400 arc seconds. The patient with the lowest distance acuity, near acuity, and stereopsis also had significant retinal comorbidities contributing to limited visual outcomes. Conclusions: To the authors' knowledge, this is the first report of Eyehance lens use in children. Enhanced monofocal specialty lenses can be safe and effective in select pediatric patients, yielding good distance and near vision, and preservation of stereopsis.
Uddin et al. (Thu,) studied this question.