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Visual rehabilitation by scleral fixation of posterior chamber intraocular lenses in Omani children with aphakia.

AbstractBACKGROUND AND OBJECTIVE:
To report indications and outcomes of scleral-fixated posterior chamber intraocular lenses (PC IOLs) in Omani children with aphakia.
PATIENTS AND METHODS:
Patients with aphakia who were younger than 16 years, unsuitable for spectacle or contact lens correction, and without capsular support underwent an anterior vitrectomy and 10-0 polypropylene inside-out scleral fixation ofa PC IOL.
RESULTS:
Scleral-fixated PC IOLs were implanted in 28 eyes of 24 patients. Group A comprised 10 (36%) eyes with congenital cataract and 3 (11%) eyes with ectopia lentis and group B comprised 15 (53%) eyes with traumatic cataract. The mean age at implantation was higher in group A (10.5 years) than in group B (7.3 years). Visual acuity improved in 17 of 28 (61%) eyes and remained at the preoperative levels in 11 of 28 (39%) eyes. Mean postoperative refraction was within +/- 2.0 diopters of the predicted refraction in 19 of 28 (68%) eyes. Complications included temporary intraocular pressure increase, vitreous hemorrhage, and iris capture with lens malposition.
CONCLUSION:
Scleral-fixated PC IOLs are beneficial for children with aphakia without posterior capsular support who are lacking other means for visual rehabilitation. Patients with traumatic cataract and lens dislocation are more likely to experience an improvement in visual acuity postoperatively than patients with congenital cataract. However, this procedure is technically more difficult than routine PC IOL implantation and potentially carries greater risks.
AuthorsAnuradha Ganesh, Sana Al-Zuhaibi, Sandip Mitra, Buthaina I Saad Sabt, Shyam S Ganguly, Alexander A Bialasiewicz
JournalOphthalmic surgery, lasers & imaging : the official journal of the International Society for Imaging in the Eye (Ophthalmic Surg Lasers Imaging) 2009 Jul-Aug Vol. 40 Issue 4 Pg. 354-60 ISSN: 1542-8877 [Print] United States
PMID19634738 (Publication Type: Journal Article)
Topics
  • Adolescent
  • Aphakia, Postcataract (surgery)
  • Cataract (congenital)
  • Child
  • Child, Preschool
  • Eye Injuries (surgery)
  • Humans
  • Infant
  • Lens Implantation, Intraocular (methods)
  • Lens, Crystalline (injuries)
  • Lenses, Intraocular
  • Oman
  • Postoperative Complications
  • Refraction, Ocular (physiology)
  • Sclera (surgery)
  • Suture Techniques
  • Vision Disorders (rehabilitation)
  • Visual Acuity (physiology)
  • Visually Impaired Persons (rehabilitation)
  • Vitrectomy

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