[Cataracts extraction combined with multifocal intraocular lens optic implantation in Berger space in school-age children with cataracts].

To evaluate the safety and efficacy of cataract extraction combined with multifocal intraocular lens (IOL) optic implantation in Berger space in school-age children with cataracts. It was a prospective study. The clinical data of school-age children with cataract who underwent cataract extraction combined with multifocal IOL implantation at Qingdao Eye Hospital of Shandong First Medical University from January 2019 to June 2023 were collected. Preoperatively, the examinations of best corrected distance, intermediate and near visual acuity, intraocular pressure, eye position, slit lamp microscopy, and fundus examination were carried out. The optical quality analysis system was used to obtain the objective visual quality indexes such as modulation transfer function cut-off frequency (MTF cut-off), Strehl ratio (SR), and objective scattering index (OSI), and stereopsis was examined. All patients underwent cataract extraction combined with multifocal IOL optic implantation in Berger space. During the follow-up, visual acuity, intraocular pressure, stereopsis, objective visual quality, anterior segment and fundus conditions were examined, and optical coherence tomography (OCT) was used to determine whether there was macular edema and other fundus abnormalities. A total of 43 cataract patients (86 eyes) were included, with an age of (9.4±3.0) years. Among them, 81 eyes completed cataract extraction combined with multifocal IOL optic implantation in Berger space. The follow-up time was (20.6±13.1) months. During the follow-up, the visual axis remained clear in all eyes. Transient postoperative intraocular hypertension occurred in 5 eyes (25-30 mmHg, 1 mmHg=0.133 kPa), which mostly occurred within 1 week after surgery and could be controlled to the normal range within 2 weeks after drug treatment. During the follow-up, no posterior synechia, secondary glaucoma, IOL decentration, pigmentary IOL deposits, retinal detachment, cystoid macular edema, proliferation of the vitreous anterior boundary membrane, capsular contraction and proliferation, etc. were observed. The preoperative and postoperative best corrected distance visual acuity (logarithm of the minimum angle of resolution) was 0.74±0.56 and 0.07±0.14, respectively, with a statistically significant difference (<0.001). The best corrected distance visual acuity was≥20/40 in 77 eyes (95.06%), and≥20/29 in 73 eyes (90.12%). The postoperative spectacle independence rate was 77.8% (63/81), and the remaining patients only needed to wear a pair of glasses to correct the reserved or residual refractive error. A total of 5 patients (11.6%) had myopia drift after surgery. The MTF cut-off and SR increased and the OSI decreased after surgery (all <0.001); the stereopsis was significantly improved (<0.05). Multifocal IOL optic implantation in Berger space showed no significant complications and can effectively improve the visual function of school-age children with cataracts. After the correction of distance visual acuity, glasses for near visual acuity are not required.