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Rotating the Intraocular Lens to Prevent Posterior Capsular Opacification in Cataract Surgeries
Published on: July 7, 2023
[Advantages of the bag-in-the-lens intraocular lens in pediatric cataract surgery]
M-J Tassignon1, L Gobin, I De Veuster
1Antwerp University Hospital, Department of Ophthalmology, Antwerp, Belgium. marie-jose.tassignon@uza.be
Insights
The bag-in-the-lens intraocular lens offers advantages in pediatric cataract surgery, improving visual acuity and reducing complications. This technique is especially beneficial for children requiring specific surgical approaches.
Area of Science:
- Ophthalmology
- Pediatric Surgery
- Biomedical Engineering
Background:
- Cataract surgery in children presents unique challenges.
- Traditional methods may require adjunct procedures like anterior vitrectomy.
- The bag-in-the-lens (BIL) intraocular lens (IOL) offers a novel approach.
Purpose of the Study:
- To evaluate the advantages of the bag-in-the-lens (BIL) intraocular lens (IOL) in pediatric cataract surgery.
- To assess visual outcomes and complications associated with BIL IOL implantation in children.
- To determine the suitability of BIL IOLs in specific pediatric cataract cases.
Main Methods:
- Prospective study of 54 eyes in 37 children (2 months to 14 years) undergoing cataract surgery with BIL IOL.
- Follow-up included slit-lamp examination, intraocular pressure, visual acuity, and refraction.
- Data collected from December 1999 to January 2008.
Main Results:
- Mean visual acuity improved significantly from 0.2 to 0.8 postoperatively.
- Refraction remained stable over time in children over 2 years old.
- Epithelial cell migration to the visual axis was minimal (93.8% of eyes).
- Less favorable outcomes were noted in cases with hyperplastic persistence of the vitreous.
Conclusions:
- The bag-in-the-lens implant is indicated for pediatric cataract surgery, particularly when posterior capsulorhexis and optic capture are recommended.
- This technique minimizes the need for anterior vitrectomy.
- It is particularly useful in eyes with proliferative hyperplastic vitreous.
Objective:
Evaluate the advantages of the bag-in-the-lens intraocular lens in children undergoing cataract surgery.
Patients And Methods:
This prospective study included 54 eyes of 37 children and babies (age, 2 months to 14 years), consecutively operated on between December 1999 and January 2008 for unilateral or bilateral cataract using the "bag-in-the-lens" intraocular lens. Slit-lamp examination, intraocular pressure, visual acuity, and refraction were followed to the best possible degree over time.
Results:
The mean age of the 37 children at the last consultation visit was 8.3+/-4.9 years. The mean visual acuity improved from 0.2+/-0.1 to 0.8+/-0.3. On the other hand, visual acuity improvement in children presenting hyperplastic persistence of the vitreous was less favorable with a postoperative average visual acuity of 0.14+/-0.18. The mean postoperative refraction in 13 children (26 eyes) operated on for bilateral cataract was 0.5+/-1.5 D for eyes showing axial lengths with substantial variation. The refraction was stable over time in children over 2 years of age. Once the implant was positioned correctly, the remaining epithelial cells of the lens did not migrate toward the visual axis, which was the case in 93.8% of all eyes and in 100% of children over 1 year of age.
Conclusions:
The "bag-in-the-lens" implant is particularly indicated in children in whom posterior rhexis and optic capture have been recommended since 1994. The implantation minimizes the use of anterior vitrectomy in pediatric cataract surgery, limiting it to those eyes presenting a proliferative hyperplastic vitreous.
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