Endoscopic-Assisted Scleral Fixated IOL in the Management of Secondary Aphakia in Children

Abstract EN

Purpose.

To evaluate the short-term postoperative outcomes in endoscopic-assisted sclera fixation intraocular lens (IOL) for the management of secondary aphakia in children.

Methods.

This is a prospective study, whereas 40 aphakic eyes with absence of a good capsular support were implanted by endoscopy-assisted sclera fixation technique.

Results.

No major intraoperative complications were recorded.

All cases were followed up for 6 months.

Only transient ocular hypertension occurred in 10 (25%) eyes.

Lens decentration and/or tilting were clinically detected in 2 eyes (5%).

Ultrasonic biomicroscopic (UBM) examination revealed lens tilting in 2 (5%) of the operated eyes, despite the proper haptics positioning in the ciliary sulcus.

Postoperative vitreous hemorrhage was reported in 5 eyes (12.5%) in the early postoperative period and retinal detachment in one eye.

A postoperative refractive astigmatism ranging from 0.75 D to 3.75 D (mean 1.7 D ± 0.79) was recorded, as compared to mean preoperative values of 2.00 D, with no statistically significant differences being recorded ( p ≥ 0.05 ).

An improvement of BCVA, 1-2 lines on Snellen chart at the end of the follow-up period, was detected in 23 eyes (57.5%) with a mean of 0.6 ± 0.08 SD, as compared to a preoperative mean values of 0.5 ± 0.07 SD ( p ≥ 0.05 ).

Conclusion.

Using an endoscope for transscleral suturing of intraocular lenses in aphakic pediatric eyes might be considered as being an effective technique that can reduce surgical complications, especially postoperative lens decentration.