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Sclerally fixated posterior chamber IOLs beneficial in children lacking capsular support

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Implanting sclerally fixated posterior chamber IOLs can be visually beneficial in certain children whose eyes lack capsular support, according to a study by researchers in Iran. However, the investigators documented a high rate of complications during long-term follow-up.

Reza Asadi, MD, and Ahmad Kheirkhah, MD, evaluated the long-term efficacy of primary or secondary implantation of transsclerally fixated posterior chamber IOLs in 25 eyes of 23 children who averaged 79 months of age.

Surgeons performed primary IOL implantation in six eyes that developed lens subluxation due to Marfan's syndrome. Secondary IOL implantation was performed in the other 19 eyes after surgery for congenital cataract (three eyes) or traumatic cataract (16 eyes), according to the study.

All eyes had inadequate capsular support, and all cases treated with secondary IOL implantation were intolerant to wearing contact lenses, the authors noted.

At 81.1 months mean follow-up, best corrected visual acuity had improved by more than one line in 12 eyes (48%).

"The main cause of reduced vision was corneal and retinal pathologies and amblyopia," the authors said.

Regarding complications, 13 eyes (52%) experienced transient intraocular hemorrhages, two eyes (8%) experienced transient choroidal effusion, one eye (4%) developed late endophthalmitis, one eye (4%) developed a retinal detachment and six eyes (24%) experienced late IOL dislocation due to broken sutures at 7 to 10 years after surgery, according to the study, published in the January issue of Ophthalmology.