V4B implantable collamer lens versus Intacs corneal rings to manage anisometropic myopic amblyopia in children.

OBJECTIVE: To compare the safety and efficacy of phakic intraocular lens (PIOL) versus intrastromal corneal ring segments (Intacs), for correcting high myopic anisometropia in amblyopic children.

DESIGN: Nonrandomized prospective multi-center study.

PARTICIPANTS: Thirty children, aged between 4 and 12 years, with unilateral high myopic anisometropic amblyopia were included in this study.

METHODS: Patients who were prospectively subdivided into group A, with mean preoperative manifest refraction spherical equivalent (MRSE) of -12.96 ± 4.17 D, underwent unilateral phakic posterior chamber intraocular lens implantation. Patients with mean preoperative MRSE of -8.60 ± 1.16 D in group B were treated by Intacs corneal rings. Pre- and postoperative visual acuity, ocular examination, stereoacuity, axial biometry measurements, cycloplegic refraction, and endothelial cell counts were performed in all patients.

RESULTS: Group A revealed prevention of amblyopia with improvement in spectacle-corrected distance visual acuity, where 4-6 lines were achieved in 77% of children, 2-3 lines in 4%, and just 0-1 lines restricted to 19% of children. Improvement in stereoacuity was noted in 93.33% of group A cases, whereas group B showed fewer cases of successfully improved vision, with 4-6 lines in 70% of children, 2-3 lines in 3%, and just 0-1 lines restricted to 27% of children. Improvement in stereoacuity was noted in 86.66% of cases. Two cases of cataract and 1 case of glaucoma with 1 case of uveitis were noted in the implantable contact lens (ICL) group.

CONCLUSIONS: Posterior chamber PIOLs or Intacs may provide a safe alternative in treating anisometropic myopic patients. Intacs implantation is safer with fewer complications than ICL. However, ICL implantation is advantageous over the corneal ring segment procedure owing to the wide range of errors to correct.