Abstract
PurposeTo evaluate the long-term outcomes of ciliary sulcus versus capsular bag fixation of intraocular lenses (IOLs) in children after pediatric cataract surgery.MethodsIOL was implanted in the ciliary sulcus in 21 eyes of 14 children, and in the capsular bag in 19 eyes of 12 children for the treatment of pediatric cataract in an institutional setting. Ultrasound biomicroscopy (UBM) was performed. Main outcome measures included IOL decentration, IOL tilt, anterior chamber depth (ACD), angle-opening distance at 500 μm (AOD500), trabecular-iris angle (TIA), best-corrected visual acuity (BCVA), intraocular pressure (IOP), and incidence of postoperative complications.ResultsThe mean follow-up period was 6.81 ± 1.82 years. Comparing to the capsular bag fixation group, the ciliary sulcus fixation group had higher vertical IOL decentration, horizontal IOL tilt, and vertical IOL tilt (p = 0.02, 0.01,0.01, respectively), higher incidence of iris-IOL contact and peripheral anterior synechia (p = 0.001, 0.03, respectively), smaller ACD, AOD500, and TIA (p = 0.02, 0.03, 0.04, respectively), higher mean IOP (17.10 ±6.06 mmHg vs.14.15± 4.74 mmHg, p = 0.01), and higher incidence of secondary glaucoma (28.57% vs. 10.53%, p = 0.007).There was no significant difference between the two groups with regard to the BCVA, refractive errors, incidence of myopic shift, nystagmus, strabismus, and visual axis opacity.ConclusionsCiliary sulcus fixation of IOLs in pediatric eyes may increase IOL malposition and crowding of the anterior segment, and may associate with a higher risk of secondary glaucoma compared to capsular bag fixation of IOLs.
Highlights
Pediatric cataracts are a major cause of childhood blindness affecting approximately 200,000 children worldwide, with an estimated prevalence ranging from three to six per 10,000 live births [1,2,3]
Ciliary sulcus fixation of intraocular lenses (IOLs) in pediatric eyes may increase IOL malposition and crowding of the anterior segment, and may associate with a higher risk of secondary glaucoma compared to capsular bag fixation of IOLs
The study group was comprised of eyes with IOL implanted in ciliary sulcus, and the control group was comprised of eyes with IOL implanted in the capsular bag
Summary
Pediatric cataracts are a major cause of childhood blindness affecting approximately 200,000 children worldwide, with an estimated prevalence ranging from three to six per 10,000 live births [1,2,3]. Intraocular lens (IOL) implantation in the pediatric cases is a generally accepted alternative form of optical correction to contact lenses and spectacles [4]. A posterior chamber IOL (PCIOL) inserted into the capsular bag is always preferred during cataract surgery. In certain circumstances, the PCIOL is placed in the ciliary sulcus in the case of intraoperative posterior capsule rupture, rupture of the zonules of Zinn, or secondary IOL implantation [5]. The safety and effect of ciliary sulcus fixation of PCIOL has been well established and accepted in adult patients if the remaining lens capsule is sufficient and strong enough to secure the IOL [6,7]. Little is known regarding the long-term outcome and safety of ciliary sulcus fixation of IOL in pediatric cases. Children have a much longer life span after cataract removal and IOL implantation
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
