Retro-pupillary iris fixated intraocular lens in pediatric subluxated lens

Abstract

Aims: The aim of this study was to evaluate the post-operative visual acuity and complications in pediatric patients with ectopia lentis who underwent lens removal and retro-pupillary iris fixated intraocular lens (IOL) implantation. Settings and Design: Retrospective, single center, 5-year clinical audit. Materials and Methods: A retrospective analysis of all pediatric cases who presented with lens subluxation and who underwent lens extraction with posterior iris claw implantation was performed over a period of 5 years from March 2008 to February 2013. A detail record of visual acuity, slit lamp examination and fundus examination was carried out. The iris claw IOL used in this case series had a 5.5/4.5 mm optic and 8/9 mm overall length. After lens removal iris claw, IOL was enclaved to the posterior surface of the iris. The main indications for surgery were reduced visual acuity and monocular diplopia. The main outcome measure was pre-operative and post-operative best corrected visual acuity (BCVA) and secondarily post-operative complications. Results: The study involved 36 eyes of 20 patients who underwent iris claw implantation showed improvement in mean BCVA from 2/60 pre-operatively to 6/18 post-operative. The mean age of the presentation was 12 years. Post-operative outcome in all patients was good. Only one patient developed traumatic dis-enclavation with subluxation of the iris claw IOL at 6 months in which re-enclavation was performed with success. The mean follow-up period was 7 months. No eye had serious complication such as cystoid macula edema, infection, glaucoma and dislocation of IOL. Conclusions: Retro-pupillary iris fixation of IOL is a simple, safe and viable option for correction of ectopia lentis in pediatric group.