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Outcomes of sutureless and sutured scleral fixated intraocular lens in paediatric population
1Vitreoretina Services, Aravind Eye Hospital and Postgraduate Institute of Ophthalmology, Pondicherry, India.
Insights
Sutureless and sutured scleral-fixated intraocular lenses (SFIOL) effectively treat paediatric aphakia. Sutureless SFIOL offers a safe alternative for children, though further research is recommended.
Area of Science:
- Ophthalmology
- Paediatric Ophthalmology
- Intraocular Lens Implantation
Background:
- Aphakia in children presents unique challenges for visual rehabilitation.
- Scleral-fixated intraocular lenses (SFIOL) are an option for managing paediatric aphakia.
- Evaluating both sutured and sutureless SFIOL techniques is crucial for optimizing outcomes.
Purpose of the Study:
- To compare the outcomes of sutureless versus sutured scleral-fixated intraocular lenses (SFIOL) in paediatric patients.
- To assess the safety and efficacy of SFIOL implantation in children under 18 years of age.
Main Methods:
- Retrospective case series conducted at a tertiary eye care institute in Southern India.
- Data collected from January 2010 to December 2018, including demographics, pre-operative characteristics, and visual acuity.
- Analysis of early and late post-operative complications and visual outcomes at 1, 6, and 12 months post-surgery.
Main Results:
- Sutureless SFIOL was performed in 80% of the 45 eyes studied.
- Statistically significant improvement in uncorrected visual acuity (UCVA) was observed at 1-month follow-up.
- Common early complications included hypotony and vitreous hemorrhage; late complications included haptic exposure.
Conclusions:
- Both sutured and sutureless SFIOLs are suitable for rehabilitating paediatric aphakia.
- Sutureless scleral fixation is a safe alternative in the paediatric population.
- Prospective studies with extended follow-up are necessary to further validate these findings.
Purpose:
To analyse the outcomes of sutureless and sutured scleral fixated intraocular lenses (SFIOL) in paediatric population.
Setting:
Vitreoretina department of a tertiary eye care institute in Southern India.
Design:
Retrospective case series.
Methods:
Data were collected from January 2010 to December 2018 for children less than 18 years of age, based on the following parameters: demographics, pre-operative characteristics, duration between aphakia and surgery, previous amblyopia treatment, the uncorrected (UCVA) and the best corrected visual acuity (BCVA) at baseline and, 1,6 and 12 months or final visit. Early and late post-operative complications along with details of any resurgery was recorded.
Results:
The study included 45 eyes of 43 patients. The mean age when children became aphakic was 8.8±3.6 years and the mean age at SFIOL implantation 10.1 ± 3.9 years. Sutureless SFIOL was performed for 36 (80%) eyes. The improvement in UCVA was statistically significant at 1-month follow up. Transient hypotony (n = 3), vitreous hemorrhage (n = 7) and raised IOP (n = 4) were the most observed early post-operative complications, while haptic exposure or disinsertion (n = 4, 9%) was a delayed postoperative complication. The mean spherical equivalent at the last follow up was 1.96 ± 0.83D and mean postoperative cylinder 2.32 ± 1.3D. The children were followed up for a mean duration of 20 ± 21.7 months. History of previous vitrectomy was found to be associated with two line reduction in UCVA (95% CI = 0.03-0.5 logMAR, p = 0.008).
Conclusion:
SFIOLs- sutured and sutureless; both were suitable for the rehabilitation of paediatric aphakia. Sutureless scleral fixation is a safe alternative for children but prospective studies with longer follow-up are needed.
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