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Ravi Shah, Charity Grannis, Lingkun Kong, Mitchell Weikert, Marshall B Hamill, Kimberly Yen; Long term outcomes of iris-fixated intraocular lenses in pediatric patients. Invest. Ophthalmol. Vis. Sci. 2015;56(7 ):686.
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To report the long term outcomes and complications of iris-fixated posterior chamber intraocular lenses (PCIOLs) in the pediatric population.
This was a retrospective observational case study involving 12 consecutive pediatric patients (17 eyes) who underwent placement of foldable iris-sutured PCIOLs between September 2004 and September 2007 by two anterior segment surgeons at a single academic center. Outcome measures included change in visual acuity and complications.
Of the 17 eyes were reviewed, 6 (35%) had hereditary or idiopathic ectopia lentis, 5 (29%) had Marfan syndrome, 2 (12%) were aphakic after PPV and 4 (24%) were aphakic after surgical intervention for trauma. Average follow up was 4.69 ± 3.21 years and mean age of surgery was 7.21 ± 3.78 years. 7 eyes suffered dislocation of the IOL an average of 12.11 ± 11.97 months after surgery with 2 patients undergoing dislocation a second time. There was a higher rate of dislocation in patients with a history of ectopia lentis due to Marfan syndrome, idiopathic, or hereditary causes than in patients being treated for aphakia resulting from other causes (71% vs 29%). Mean VA improved in 12 of 17 (71%) patients, from 0.80 ± 0.6 LogMar pre-op to 0.35 ± 0.5 LogMar at most recent visit, p=0.009. One eye of a Marfan patient sustained a retinal detachment eight months after dislocation of the PCIOL, and one patient experienced iris capture of the IOL after surgery.
Iris fixated intraocular lenses have been used as an alternative to transsclerally sutured IOLs to correct aphakia in pediatric patient. Dislocation of the IOLs can occur frequently, however, and there is concern for suture degradation over time. The procedure should be considered with caution in pediatric patients.
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