Pediatric transscleral sutured intraocular lenses: Efficacy and safety in 43 eyes followed an average of 3 years

Is an iris claw IOL a good option for correcting surgically induced aphakia in children? A review of the literature and illustrative case study

“…It has been successfully implanted in children with congenital cataract, myopic anisometropic amblyopia, and subluxated lenses. 1,7,8 However, concerns regarding chronic endothelial cell loss (ECL) and the risk of lens de-enclavation from the iris have continued, in part, owing to lack of data in the literature for these cases.…”

Safety of transscleral-sutured intraocular lenses in children

“…9,10 As the adult experience became more extensive and the early problems with suture exposure were resolved by newer surgical techniques, the number and types of pediatric patients undergoing this procedure expanded. [11][12][13][14] In children, this procedure typically is reserved for 3 types of cases: (1) patients who have had severe enough trauma to disrupt zonular support sufficiently to make sulcus or capsular bag fixation risky; (2) patients who have had a complete lensectomy, either as part of congenital cataract removal or some other ocular procedure; and (3) patients who have subluxated lenses that are idiopathic or the result of Marfan syndrome or familial ectopic lentis. Numerous reports have claimed that this approach was safe, effective, and caused few complications in the pediatric age group.…”

“…The follow-up has been relatively short, with the longest averaging only 3 years (Table 1). 11,12,14,15 Recently, a new concern has been raised in adults about the long-term safety of using a 10-0 polypropylene (Prolene) suture to fixate the IOL to the scleral wall. Polypropylene is a monofilament polymer composed of propene (CH 2 ϭ CHCH 3 ), configured as an isotactic crystalline polypropylene stereoisomer.…”

Scleral Fixated Posterior Chamber Intraocular Lens for Children with Traumatic Cataract

“…4 Another early postoperative complication vitreous hemorrhage is reported 1-52% in the literature in pediatric patients who had undergone SFIOL surgery. 15,21 In our study we encountered this complication in 36.4% of the patients. Contrary to expectations this frequency was similar to those children who did not experienced ocular trauma.…”

“…18.2% of the patients had postoperative high IOP levels and this was similar with the previous studies. 15,17,21 The patients with high IOP levels were treated successfully and none of the patients developed refractory glaucoma. None of the patients had suture erosion, irritation and endophthalmitis.…”