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Sofia Bravo-Beltranena, Martin Zimmermann-Paiz, Erick Hernandez Bogantes; Case Series of Pediatric Sutured Scleral Lens Fixation in Guatemala City. Invest. Ophthalmol. Vis. Sci. 2018;59(9):5815.
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Controversy exists regarding the use and outcomes of pediatric sutured scleral intraocular lens fixation. We present the short-term outcomes, stability and complications of pediatric patients with sub-luxated intraocular lens, aphakia and ectopia lentis.
A retrospective, observational case-series of 9 patients (13 eyes) that underwent sutured scleral fixation intraocular lens (IOL) to correct sub-luxated IOL, aphakia or ectopia lentis, between January 2005 and December 2015 in a single academic center in Guatemala City, were reviewed. Demographic data, changes in pre and post-operative corrected distance visual acuity (CDVA), stability of the IOL (descentration and tilt) and complications were evaluated. Every patient less than 14 years-old with a sutured scleral IOL fixation procedure was included for review. Patients with insufficient data or loss to follow-up were excluded. A t student test was applied to assess the difference between pre and postoperative visual acuity.
A total of 4 patients (5 eyes); 2 male and 2 female, with a mean age of 8.2 years ± 1.7 and a median follow-up of 8 months (range from 2 - 35 months) were included in the study. Indications for sutured scleral fixation IOL were sub-luxated IOL after congenital cataract surgery, lensectomy due to ectopia lentis and, inadequate capsular support because of trauma. The average preoperative CDVA was 1.2 logMAR, and the average postoperative CDVA was 0.82 logMAR. The gain in vision postoperatively was not statistically significant (p = 0.13669). The lens was well centered in all cases and none of the patients had surgical complications during the follow-up. One eye subsequently developed a retinal detachment. A total of 8 eyes were excluded, due to insufficient data and lost to follow-up.
In this case-series, the correction of aphakia, ectopia lentis and previous IOL complications yielded to good results in terms of stability and safety. Visual rehabilitation is important to obtain better visual outcomes.
This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.
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