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Long-Term Outcomes of Iris-sutured Posterior Chamber Intraocular Lenses in Children
Ravi Shah1, Mitchell P Weikert1, Charity Grannis2
1Department of Ophthalmology, Baylor College of Medicine, Houston, Texas.
Insights
Iris-sutured posterior chamber intraocular lenses (PCIOLs) in children showed improved visual acuity but a high rate of dislocation, particularly in those with ectopia lentis. Caution is advised for this pediatric PCIOLs procedure.
Area of Science:
- Ophthalmology
- Pediatric ophthalmology
- Ophthalmic surgery
Background:
- Iris-sutured posterior chamber intraocular lenses (PCIOLs) are an alternative to transsclerally sutured lenses for pediatric aphakia.
- Long-term outcomes and complications in pediatric patients are not well-documented.
Purpose of the Study:
- To evaluate the long-term outcomes and complications of iris-sutured PCIOLs in pediatric patients.
- Assess the safety and efficacy of this surgical approach in a young population.
Main Methods:
- Retrospective interventional case study of 12 pediatric patients (17 eyes).
- Involved foldable iris-sutured PCIOLs implanted between September 2004 and September 2007.
- Outcome measures included visual acuity changes and complication rates.
Main Results:
- Average follow-up was 4.69 years; mean age at surgery was 7.21 years.
- Seven eyes (41%) experienced PCIOL dislocation, with a higher incidence in patients with ectopia lentis (71% vs 29%).
- Mean visual acuity improved significantly (P = .009), but complications like retinal detachment and iris capture occurred.
Conclusions:
- Iris-sutured PCIOLs can improve vision in pediatric aphakia.
- Frequent dislocation is a significant complication, especially in patients with underlying conditions.
- The procedure requires careful consideration due to potential risks in pediatric patients.
Purpose:
To report the long-term outcomes and complications of iris-sutured posterior chamber intraocular lenses (PCIOLs) in the pediatric population.
Design:
Retrospective interventional case study.
Methods:
This study involved 12 consecutive pediatric patients (17 eyes) who underwent placement of foldable iris-sutured PCIOLs between September 2004 and September 2007. Outcome measures included change in visual acuity and complications.
Results:
Of the 17 eyes were reviewed, 6 (35%) had hereditary or idiopathic ectopia lentis, 5 (29%) had Marfan syndrome, 2 (12%) were aphakic after pars plana vitrectomy 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. Seven eyes suffered dislocation of the PCIOL 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 causes, or hereditary causes than in patients being treated for aphakia resulting from other causes (71% vs 29%). Mean visual acuity improved in 12 of 17 patients (71%), from 0.80 ± 0.6 logMAR preoperatively to 0.35 ± 0.5 logMAR at most recent visit, P = .009. One eye of a Marfan patient sustained a retinal detachment 8 months after dislocation of the PCIOL, and 1 patient experienced iris capture of the PCIOL after surgery.
Conclusions:
Iris-sutured intraocular lenses have been used as an alternative to transsclerally sutured intraocular lenses to correct aphakia in pediatric patients. Dislocation of the intraocular lenses can occur frequently, however. The procedure should be considered with caution in pediatric patients.
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