Intraocular Lens Techniques in Pediatric Eyes with Insufficient Capsular Support: Complications and Outcomes

Intraocular lens (IOL) implantation in pediatric eyes with insufficient capsular support is challenging and there are multiple IOL options. These include placement of an IOL within the capsular bag with a capsular tension ring, a scleral-fixated posterior-chamber IOL (PCIOL) with or without capsular tension segment or ring, an intra-scleral fixated IOL, an iris-sutured PCIOL, or an anterior chamber iris-fixated IOL. We reviewed 48 articles and 1 published abstract describing the surgical techniques, complications and visual outcomes of different IOL options in the management of aphakic pediatric eyes with insufficient capsular support. The present review found that the visual acuity outcomes of various IOLs are comparable. Furthermore, each IOL design and surgical technique has different rates of serious complications, including IOL dislocation or decentration, intraocular hemorrhage, glaucoma, endothelial cell loss, and endophthalmitis. An understanding of the risks and benefits of different IOL designs is important for counseling patients and families.