Korean J Ophthalmol.  2009 Sep;23(3):148-152. 10.3341/kjo.2009.23.3.148.

Unilateral Scleral Fixation of Posterior Chamber Intraocular Lenses in Pediatric Complicated Traumatic Cataracts

• Hyun DW
• Lee TG
• Cho SW

• KMID: 1115744
• DOI: http://doi.org/10.3341/kjo.2009.23.3.148

Abstract

PURPOSE
The purpose of this study was to evaluate the visual outcomes and complications of unilateral scleral fixation of posterior chamber intraocular lenses (SF-PCIOLs) in pediatric complicated traumatic cataracts without capsular support. METHODS: This study involved five eyes of five children who underwent unilateral SF-PCIOL. All patients had a unilateral complicated traumatic cataract associated with anterior or posterior segment injury. Visual acuity (VA), IOL position, and postoperative complications were assessed during follow-up. RESULTS: The mean age of patients at the time of SF-PCIOL was 90 months (range, 66-115). The mean duration of follow-up time after surgery was 22 months (range, 5-55). In all patients, the best-corrected VA was either improved or was stable at last follow-up following SF-PCIOL implantation. There were no serious complications. CONCLUSIONS: Unilateral scleral fixation of PCIOL can be a safe and effective procedure for pediatric, unilateral, complicated traumatic cataracts without capsular support in selected cases.

Keyword

Children; Pediatric traumatic cataract; Scleral fixation of posterior chamber IOL (SF-PCIOL)

MeSH Terms

Anterior Eye Segment/injuries
Aphakia, Postcataract/*surgery
Cataract/*etiology/physiopathology
Child
Child, Preschool
Endophthalmitis/etiology
Eye Injuries/*complications
Female
Follow-Up Studies
Humans
Lens Implantation, Intraocular/*methods
Male
Postoperative Period
Retrospective Studies
Sclera/*surgery
*Suture Techniques
Visual Acuity

Reference

1. Stamler JF. The complications of contact lens wear. Curr Opin Ophthalmol. 1998. 9:66–71.

2. Buckley EG. Hanging by a thread: The long term efficacy and safety of transscleral sutured intraocular lenses in children (An American ophthalmological society thesis). Trans Am Ophthalmol Soc. 2007. 105:294–311.

3. Johnston RL, Charteris DG, Horgan SE, Cooling RJ. Combined pars plana vitrectomy and sutured posterior chamber implant. Arch Ophthalmol. 2000. 118:905–910.

4. Sharpe MR, Biglan AW, Gerontis CC. Scleral fixation of posterior chamber intraocular lenses in children. Ophthalmic Surg Lasers. 1996. 27:337–341.

5. Lam DS, Ng JS, Fan DS, et al. Short term results of scleral intraocular lens fixation in children. J Cataract Refract Surg. 1998. 24:1474–1479.

6. Kumar M, Arora R, Sanga L, Sota LD. Scleral-fixated intraocular lens implantation in unilateral aphakic children. Ophthalmology. 1999. 106:2184–2189.

7. Zetterstrom C, Lundvall A, Weeber H Jr, Jeeves M. Sulcus fixation without capsular support in children. J Cataract Refract Surg. 1999. 25:776–781.

8. Buckley EG. Scleral fixated (sutured) posterior chamber intraocular lens implantation in children. J AAPOS. 1999. 3:289–294.

9. Jacobi PC, Dietlein TS, Jacobi FK. Scleral fixation of secondary foldable multifocal intraocular lens implants in children and young adults. Ophthalmology. 2002. 109:2315–2324.

10. Ozmen AT, Dogru M, Erturk H, Ozcetin H. Transsclerally fixated intraocular lenses in children. Ophthalmic Surg Lasers. 2002. 33:394–399.

11. Sewelam A. Four-point fixation of posterior chamber intraocular lenses in children with unilateral aphakia. J Cataract Refract Surg. 2003. 29:294–300.

12. Bardorf CM, Epley KD, Lueder GT, Tychsen L. Pediatric transscleral sutured intraocular lenses: efficacy and safety in 43 eyes followed an average of 3 years. J AAPOS. 2004. 8:318–324.

13. Asadi R, Kheirkhah A. Long-term results of scleral fixation of posterior chamber intraocular lenses in children. Ophthalmology. 2008. 115:67–72.

14. Maya ET, Steven M, Archer SM, et al. Intraocular lens power calculation in children. Ophthalmol. 2007. 52:474–482.

15. Awner S, Buckley EG, DeVaro JM, Seaber JH. Unilateral pseudophakia in children under 4 years. J Pediatr Ophthalmol Strabismus. 1996. 33:230–236.

16. Buckley EG, Klomberg LA, Seaber JH, et al. Management of the posterior capsule during pediatric intraocular lens implantation. Am J Ophthalmol. 1993. 115:722–728.

17. Johnston RL, Charteris DG. Pars plana vitrectomy and sutured posterior chamber lens implantation. Curr Opin Ophthalmol. 2001. 12:216–221.

18. Vote BJ, Tranos P, Bunce C, et al. Long-term outcome of combined pars plana vitrectomy and scleral fixated sutured posterior chamber intraocular lens implantation. Am J Ophthalmol. 2006. 41:308–312.

19. Assia EI, Nemet A, Sachs D. Bilateral spontaneous subluxation of scleral-fixated intraocular lenses. J Cataract Refract Surg. 2002. 28:2214–2216.

20. McCluskey P, Harrisberg B. Long-term results using scleral-fixated posterior chamber intraocular lenses. J Cataract Refract Surg. 1994. 20:34–39.

21. Altman AJ, Gorn RA, Craft J, Albert DM. The breakdown of polypropylene in the human eye: is it clinically significant? Ann Ophthalmol. 1986. 18:182–185.

22. Jongebloed WL, Worst JF. Degradation of polypropylene in the human eye: a SEM-study. Doc Ophthalmol. 1986. 64:143–152.

23. Kocak-Altintas AG, Kacak-Midillioglu I, Dengisik F, Duman S. Implantation of scleral-sutured posterior chamber intraocular lenses during penetrating keratoplasty. J Refract Surg. 2000. 16:456–458.

24. Scott IU, Flynn HW Jr, Feuer W. Endophthalmitis after secondary intraocular lens implantation. A case-report study. Ophthalmology. 1995. 102:1925–1931.

25. Ashraf MF, Stark WJ, McCannel . Azar DT, editor. Sutures and secondary iris fixated intraocular lenses. Intraocular Lenses in Cataract and Refractive Surgery. 2001. 1st ed. Philadelphia: Saunders;chap. 7.