Abstract
Purpose: :
To assess outcomes after trans-scleral sutured posterior chamber intraocular lens (SS-PCIOL) placement in children.
Methods: :
A retrospective review of pediatric patients who underwent SS-PCIOL placement identified 10 eyes of eight patients between 1999 and 2007. Patients ranged in age from 3 to 15 years at the time of surgery (mean 8.6 years). The diagnoses upon referral for secondary IOL included congenital cataract (5/10), trauma (3/10), persistent fetal vasculature (1/10), and uveitis (1/10). Post-operative visual acuity, post-operative refractive errors, and complications were analyzed.
Results: :
5/10 eyes had improved best-corrected visual acuity (BCVA) post-operatively. 2/10 had a decreased post-operative BCVA of two Snellen lines or less. The remaining 3/10 had a decreased BCVA of >2 lines or were finger counting or worse post-operatively. Post-operative refractive error ranged from -1.50+0.50 x20 to +3.50+0.75 x170. Post-operative complications included retinal detachment (4/10), hypotony (2/10), vitreous hemorrhage (2/10), glaucoma (2/10), choroidal hemorrhage (1/10), cystoid macula edema (1/10), and failure of penetrating keratoplasty (1/10), necessitating subsequent surgery in 6/10 treated eyes. There were no IOL dislocations.
Conclusions: :
Although there were no lens dislocations, placement of an SS-PCIOL in children was associated with a high rate of post-operative complications. Despite the fact that this is a small case series of eyes with complex past ocular histories, it suggests that outcomes after SS-PCIOL placement in children may be worse than in adults.
Keywords: intraocular lens • sclera • amblyopia