Article
Pediatric secondary intraocular lenses implantation – 10-year clinical results
Search Medline for
Authors
Published: | September 18, 2006 |
---|
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.