Abstract
Aim This paper aims at evaluating refractive outcome and complication profile of sutureless, glueless, flapless, intrascleral fixation of intraocular lens (SFIOL) in pediatric population. Methods This retrospective study included patients ≤18 years of age who underwent SFIOL for ectopia lentis. Details obtained included preoperative uncorrected visual acuity (UCVA), cycloplegic refraction, and best-corrected visual acuity (BCVA); intraoperative complications; and postoperative UCVA, cycloplegic refraction, and BCVA and complications. Results Median pre- and postoperative UCVA was logMAR 1.78 (Snellen 20/1200) and logMAR 0.30 (Snellen 20/40), respectively, (p < 0.001). Median pre- and postoperative BCVA was logMAR 0.24 (Snellen 20/34) and logMAR 0.18 (Snellen 20/30), respectively. UCVA ≥20/60 was attained in 90% of eyes. BCVA ≥20/30 was attained in 85.0% of eyes. Most common early postoperative complications were hyphaema (10%), transient vitreous hemorrhage (2.5%), and ocular hypotony (2.5%). None of these developed any long-term sequelae. Only one case of subluxation of IOL was seen. No case of late endophthalmitis or retinal detachment was seen. Conclusion Since refractive error induced is minimal, the procedure is suitable for IOL implantation in children, who are noncompliant with spectacles. The complication profile is similar to that reported in adults.
Highlights
Optical rehabilitation of childhood aphakia, in the presence of an unstable capsule-zonule complex, is one of the most challenging tasks faced by the ophthalmologists
Long-term complications associated with anterior chamber IOL (ACIOL) and iris-fixated IOL (IFIOL) like corneal decompensation due to endothelial cell loss; chronic uveitis leading to peripheral anterior synechiae and glaucoma; and iris chaffing and pupillary constriction make them an unsafe option for children, due to their long-life expectancy [1,2,3,4,5,6,7,8,9,10]
At each follow-up, the examination included uncorrected visual acuity (UCVA), best-corrected visual acuity (BCVA), cycloplegic refraction, intraocular pressure, and a comprehensive anterior and posterior segment evaluation to see for any postoperative complications
Summary
Optical rehabilitation of childhood aphakia, in the presence of an unstable capsule-zonule complex, is one of the most challenging tasks faced by the ophthalmologists. Numerous techniques like anterior chamber IOL (ACIOL), iris-fixated IOL (IFIOL), and scleral fixated IOL (SFIOL) have been developed for such eyes [1,2,3,4,5,6,7,8].
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