Bag-in-the-lens intraocular lens in paediatric cataract surgery: intraoperative and postoperative outcomes
Nils-Erik Boonstra1, Olav H Haugen1,2
1Department of Ophthalmology, Haukeland University Hospital, Bergen, Norway.
Insights
The bag-in-the-lens (BIL) technique for pediatric cataract surgery is safe and effective. This method shows fewer complications and reoperations compared to conventional lens-in-the-bag approaches.
Area of Science:
- Ophthalmology
- Pediatric Surgery
- Medical Devices
Background:
- Cataract surgery in children presents unique challenges.
- The conventional lens-in-the-bag technique can have limitations in pediatric cases.
- The bag-in-the-lens (BIL) intraocular lens (IOL) offers a potential alternative.
Purpose of the Study:
- To evaluate the intraoperative and postoperative outcomes of the bag-in-the-lens (BIL) technique in pediatric cataract surgery.
- To assess the safety and efficacy of the BIL technique in children under 12 years old.
Main Methods:
- Retrospective case series of pediatric patients (<12 years) undergoing cataract surgery with the BIL IOL.
- Minimum follow-up period of 6 months.
- Analysis of intraoperative complications, postoperative outcomes, and need for reoperations.
Main Results:
- 50 eyes in 30 pediatric patients were operated using the BIL technique, with a median follow-up of 33.5 months.
- One case of IOL luxation and one case requiring anterior vitrectomy were reported.
- Visual axis opacification (VAO) occurred in 8% of eyes, with only one requiring reoperation.
- Postoperative iris capture occurred in two eyes, both managed surgically.
- No secondary glaucoma was observed.
Conclusions:
- The bag-in-the-lens (BIL) technique is a safe and effective surgical option for pediatric cataract.
- The BIL technique demonstrated a significantly lower rate of complications and need for additional surgery compared to the conventional lens-in-the-bag method.
Purpose:
To report intra- and postoperative surgical outcome using the bag-in-the-lens (BIL) technique in paediatric cataract surgery.
Methods:
In a retrospective case series, we studied the outcomes of children aged <12 years operated for cataract with the bag-in-the-lens intraocular lens (IOL), with a minimum of 6 months of follow-up.
Results:
Since 2013, 50 eyes in 30 patients <12 years (20 bilateral and 10 unilateral) have been operated at our department with the BIL technique, with a median follow-up time of 33.5 months (range 6-77). Median age at surgery was 49.5 months (4-139). In one case, the IOL luxated through the capsulorhexes to the vitreous, but could be secured and repositioned as planned without further difficulties. Anterior vitrectomy was necessary in one case due to prolapse of vitreous to the anterior chamber during surgery. No other intraoperative complications occurred. Visual axis opacification (VAO) developed in four eyes (8%). So far, only one of these has needed a reoperation with clearing of the secondary cataract. A complete absence of VAO was thus seen throughout the study period in 92%. In two eyes, postoperative iris capture occurred. In both cases, surgical repositioning of the iris was needed. No eyes developed secondary glaucoma during the study period.
Conclusion:
The BIL technique seems to be a safe surgical procedure in paediatric cataract, with significantly less complications and need for additional surgery compared with the conventional lens-in-the-bag technique.
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