Long‐term follow‐up of the bag‐in‐the‐lens in children

Abstract

AbstractOver the years the visual prognosis of pediatric cataract has significantly improved. Final visual outcome depends upon many factors: age of onset, uni‐ or bilaterality, pre‐ and coexisting ocular abnormalities, timing of surgery, postoperative course and complications, and adherence to amblyopia treatment. We present a series of 46 eyes implanted with the bag‐in‐the‐lens intraocular lens (BIL IOL), of which 30 bilateral and 16 unilateral eyes. A significant improvement in best‐corrected visual acuity (BCVA) was obtained in all but one case (PFV case with glaucoma) though with a significant difference between uni‐ and bilateral cases. BCVA above 0.5 was achieved in 26, and of 1.0 in 17 of the bilateral cases. Of the unilateral cases only 5 achieved a BCVA above 0.5 while none achieved 1.0. The likely reasons for the poorer outcome in unilateral cases include a higher rate of ocular comorbidity (4 cases of PFV in this series) and the increased tendency towards amblyopia in unilateral cases despite early and intensive visual rehabilitation treatment. In conclusion, the BIL IOL can be considered a safe and well‐tolerated approach for pediatric cataract with favorable visual outcomes and a low rate of VAR and other complications. Commercial interest