1. Vision-Related Quality of Life Assessment using NEI-VFQ-25 in Children With History of Phakic or Aphakic IOL Refractive Surgery. Claire Hartnett MD Michael O’Keefe FRCS The authors have no financial interest in the subject matter of this poster.

2. Purpose To assess and compare vision specific health- related quality of life in children and adolescents following refractive surgery with phakic or aphakic intraocular lens insertions. The patients were assessed using the national Eye Institute, 25 item Visual Function Questionnaire (NEI-VFQ-25, version 2000).

3. Method A retrospective chart review was carried out to identify children who had undergone insertion of phakic or aphakic intraocular lenses in order to reduce or correct their high refractive errors. The aim in was to reduce anisometropia and potential amblyopia and increase compliance with spectacle wear and ultimately improve vision for each child.

4. Method All children were requested to complete the questionnaire. The parents of the younger participants answered on their behalf. See indications for surgery each case in coming slides.

5. RESULTS 13 patients were included in the study. 8 males 5 females Ages 2 years – 16 years: Mean 10.3 years 6 Aphakic patients 5 Phakic patients 2 Pseudophakic patients

6. Aphakic Patients PtAge (yrs) SexNo. of Eyes IndicationComorbid Condition Preoperative Refraction S.E. 18F1Unilateral aphakia post traumatic cataract NilL +12.0+12.0 216M2Bilateral aphakia post lensectomy for ectopia lentis Marfan’s Syndrome R +11.5 CL ( +6.5/+2.5x108) L +12.0 CL (+9/+1x106) +11.5( +7.75) +12.0 (+9.5) 315F2Bilateral aphakia post lensectomy for ectopia lentis Marfan’s Syndrome R +6.0/+1.75 x 120 L +13.0 +7.37 +13.0 414M2Bilateral aphakia post lensectomy for ectopia lentis Fibrillin 1 gene mutation R +12.50/+1.0 x 100 L +14.0/+1.0 x 80 +13.0 +14.5 53F1Aphakia post lensectomy for ectopia lentis NilR +13.50+13.5 67M1Aphakia post lensectomy for subluxed cataractous lens NilL +14.0/+1.0 x 70+14.5 6Mean 10.5 Total 9 Mean Sph +12.0 Mean Cyl +0.52 Mean +12.3

7. Phakic Patients PtAge (yrs) SexNo. of Eyes IndicationComorbid Condition Preoperative Refraction S.E. 12F1Unilateral high myopia post retinopathy of prematurity NilL -12.50/-3.50 x 90-14.25 29M2Bilateral high myopiaSepto-optic dysplasia Nystagmus R -13.25/-1.75x90 L -14.0 -14.12 -14.0 38M2Bilateral high myopia post retinopathy of prematurity Autism Nystagmus R -18.0 L -18.0 -18.0 48M2Bilateral high myopiaNystagmusR -17.0/-2.0 x 180 L -13.0 -18.0 -13.0 58M2Bilateral high compound myopic astigmatism NilR -4.50/-6.50 x20 L -5.25/-4.25 x 160 -7.75 -7.37 5Med 8 Total 9 Mean Sph -12.83 Mean cyl 2.0D Mean -13.8

8. Pseudophakic Patients PtAge (yrs) SexNo. of Eyes IndicationComorbid Condition Preoperative Refraction S.E. 113F1Unilateral high myopia post congenital cataract extraction with primary PCIOL Nil-10.0/-2.0 x 45-11.0 215M2Bilateral high myopia post bilateral congenital cataract extraction with primary PCIOLs Trisomy 21R -15.75/-1.50 x 0 L -21.0 -16.50 -21.0 2Mean 14 Total 3 Mean Sph -15.58 Mean Cyl -1.17 Mean -16.16

9. RESULTS 8 Patients had bilateral refractive lens insertions. 5 Patients had unilateral refractive lens insertions. A greater improvement in vision-related quality of life assessment scores were recorded in patients who underwent bilateral refractive lens insertions compared with the unilateral group.

10. RESULTS In the following categories statistically significant improvement in assessment scores were obtained in the bilateral group in comparison to the unilateral group.  Difficulty with distance activities (p = 0.001)  Difficulty with near activities (p = 0.02)  Vision-specific social functioning (p = 0.003)  Role Difficulties (p = 0.05)

11. CONCLUSION Refractive surgery for children involving intraocular phakic or aphakic lens insertions can have positive effects on vision-related quality of life activities. This is especially beneficial in patients requiring bilateral surgery. This study highlights benefits that can be attained from refractive surgery in children and adolescents.