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Scleral-fixated intraocular lens implantation in unilateral aphakic children
Objective:
To assess the feasibility of scleral-fixated intraocular lens (IOL) implantation as an alternative form of optical correction in aphakic children intolerant of contact lenses and whose anterior segments lack capsular support.
Design:
Prospective, noncomparative case series.
Participants:
A total of 11 eyes of 11 unilateral aphakic children in the age group 4 to 9 years (mean, 6.45 years) were included in the study.
Intervention:
Secondary scleral-fixated IOL implantation was performed in all cases. The patients underwent anterior vitrectomy at the time of IOL implantation. Amblyopia therapy in the form of patching was given post-IOL surgery. The follow-up ranged from 4 to 18 months (mean, 10.90 months).
Main Outcome Measures:
Postoperative best-corrected visual acuity (BCVA) in comparison to preoperative visual status and complications from the procedure were analyzed.
Results:
Postoperative BCVA remained within 1 Snellen line of the preoperative visual status in six eyes, or 54.5% of patients; it improved by more than 1 Snellen line in three eyes, or 27.2% of patients, and decreased by more than 1 Snellen line in two eyes, or 18.1% of patients. The complications encountered were suture erosion through the conjunctiva in two eyes (18.18%), marked postoperative anterior chamber reaction in two eyes (18.18%), IOL decentration in one eye (9.09%), glaucoma in one eye (9.09%), and cystoid macular edema in one eye (9.09%).
Conclusion:
Secondary scleral-fixated IOL implantation was successful in achieving BCVA comparable to preoperative BCVA. However, a longer follow-up is required to document any further complications.