Abstract
Purpose To introduce an effective method for separating extensive posterior synechiae and those located under or adjacent to surgical incisions. Methods Pediatric patients who had been subjected to cataract surgery and developed troublesome posterior synechiae requiring secondary intraocular lens (IOL) implantation were recruited. All patients underwent microperipheral iridectomy at the 12 o'clock position. Then, an ophthalmic viscosurgical device was injected into the posterior chamber through the iris fistula to mechanically separate the posterior synechiae, using scissors to cut robust posterior synechiae if necessary. The results of posterior synechiolysis and the position of the implanted IOL were analyzed. Results Sixteen patients (median age, 51.56 months; range, 28–80 months) were included. The scope of posterior synechia in clock was 4.42 (range, 1–10). All troublesome posterior synechiae were successfully separated using the microperipheral iridectomy method, and all patients underwent IOL implantation in the ciliary sulcus. There was one case of peripheral iridectomy-related early intraoperative bleeding; no bleeding was observed at the end of surgery. Conclusions Microperipheral iridectomy is a useful method for the management of troublesome posterior synechiae during secondary IOL implantation in pediatric patients, which makes secondary IOL implantation an easier and safer method in some challenging cases.
Highlights
Pediatric cataract is the leading cause of blindness in children, and timely cataract surgery is crucial for restoring vision
We found that peripheral iridectomy creates a communication between the posterior and anterior chambers but may serve as a passage to separate troublesome posterior synechiae (TPS), facilitating optimal intraocular lens (IOL) implantation and ensuring central placement of the IOL. e present study was performed with the aim to introduce microperipheral iridectomy as a useful method for posterior synechiolysis, for TPS in pediatric patients who require secondary IOL implantation
Sixteen pediatric patients (19 eyes) who required secondary IOL implantation and presented with TPS were recruited in the present study. e baseline characteristics of the patients are summarized in Table 1. e mean age of the patients was 52.89 ± 17.05 months. e mean scope of the posterior synechiae in clock positions was 4.42 ± 2.61
Summary
Pediatric cataract is the leading cause of blindness in children, and timely cataract surgery is crucial for restoring vision. Due to the inherent nature of the developing eyes and the narrow anterior ocular segment in children, not all pediatric patients can immediately receive IOL implantation after cataract surgery, those aged
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