gms | German Medical Science

104th DOG Annual Meeting

21. - 24.09.2006, Berlin

Pediatric secondary intraocular lenses implantation – 10-year clinical results

Meeting Abstract

  • S. Pyrochtová - Department of Pediatric Ophthalmology, Masaryk University Hospital, Brno, Czech Republic
  • R. Autrata - Department of Pediatric Ophthalmology, Masaryk University Hospital, Brno, Czech Republic
  • J. Řehůřek - Department of Pediatric Ophthalmology, Masaryk University Hospital, Brno, Czech Republic
  • K. Šenková - Department of Pediatric Ophthalmology, Masaryk University Hospital, Brno, Czech Republic

Deutsche Ophthalmologische Gesellschaft e.V.. 104. Jahrestagung der Deutschen Ophthalmologischen Gesellschaft (DOG). Berlin, 21.-24.09.2006. Düsseldorf, Köln: German Medical Science; 2006. Doc06dogP223

The electronic version of this article is the complete one and can be found online at: http://www.egms.de/en/meetings/dog2006/06dog745.shtml

Published: September 18, 2006

© 2006 Pyrochtová et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.en). You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.


Outline

Text

Objective

To evaluate functional outcomes of variuous techniques for implanting intraocular lenses (IOL) in aphakic children in the absence of adequate capsular support and for placing a secondary IOL within the capsular bag.

Methods

78 children, aged from 36 months to 16 years (Mean 7.95 years), who originally had aphakia after cataract extraction were operated on during the period from January 1995 to January 2004. The mean follow-up time was 4.9 years (range: 2 to 8 years). Visual outcomes, refraction, and complications of 103 eyes were reviewed. Secondary PC IOL implantation with transscleral suture fixation was performed in 20 eyes, anterior chamber (AC) IOLs were implanted in 17 eyes in the absence of capsular support. Nineteen eyes had PCIOL implantation within the reopened capsular bag, in 37 eyes PC IOLs were implanted into the ciliary sulcus without suture fixation. All postoperative data are presented from the last examinations

Results

BSCVA postoperatively was preserved at 55 eyes, improved at 37 eyes (1or 2 Snellen lines gain) and worsened at 11 eyes (1or 2 Snellen lines gain) in comparison to their preoperative value. Uncorrected visual acuity (UCVA) was improved at all eyes. The mean spherical equivalent refraction preoperatively was +13.28 D (range: +9.50 to +17.25 D) and changed to +2.14 D (range -3.25 to +5.75 D). Binocular vision status was maintained at 57 children and improved at 11 children. High grade stereopsis was present at 29% of children with bilateral pseudophakia and at 10.4% of children with unilateral pseudophakia. The highest complication rate (fibrinous inflammatory response, korectopia, secondary glaucoma) was observed after AC IOL implantation cases. Posterior chamber IOLs implanted into the reopened capsular bag as well as transscleral suture fixated PC IOLs induced significantly less complications. No severe complications like endophthalmitis or retinal detachment were found.

Conclusions

PCIOLs sutured to the ciliary sulcus offer a superior option to ACIOLs for correction of childhood aphakia in children lacking capsular support. Placement of secondary IOLs within the capsular bag can be accomplished successfully for selected pediatric patients. Secondary PC IOLs implantation is a safe and effective method for correction of pediatric aphakia.