Secondary Intraocular Lens Implantation for Pediatric Aphakia

Trivedi, Rupal H.; Wilson, M. Edward; Facciani, John

doi:10.1016/j.jaapos.2005.02.010

Cited by 46 publications

(30 citation statements)

References 24 publications

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“…This included the operated eye for unilaterally affected patients and a randomly selected eye from bilaterally affected patients. The results of our study and similar other studies are reported and summarized as weighted means [4][5][6][7][8][9] in Table 2. While the precise methods vary between our study and the other reported studies, this table allows for easy comparison of the studies' data concerning secondary IOL implantation.…”

Section: Discussionsupporting

confidence: 65%

Secondary intraocular lens implantation following infantile cataract surgery: intraoperative indications, postoperative outcomes

Wood

Tadros

Trivedi

et al. 2016

Eye

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Purpose The purpose of this study was to determine the long-term complications and outcomes of secondary intraocular lens (IOL) implantation in patients with congenital cataracts. Patients and MethodsThe medical records of children operated for secondary IOL implantation surgery between 2000 and 2014 were retrospectively reviewed. Those who had undergone their initial congenital cataract surgery before 7 months of age were included and were analyzed for intra-and postoperative factors and postoperative refractive outcomes. We focused on three complications: visual axis opacification (VAO), glaucoma, and IOL exchange after at least 1 year of follow-up. Results A total of 49 eyes of 49 patients were analyzed for intraoperative indications. Of those, 37 eyes of 37 patients had at least 1 year of follow-up and were analyzed for postoperative outcomes. The mean age at secondary implantation was 55.2 ± 21.6 months. At secondary implantation, 69.4% of eyes were implanted in the capsular bag, 28.6% in the sulcus, and 2.0% that were angle-supported. There was no significant correlation between the site of secondary IOL implantation and age at implantation (P = 0.216). The mean follow-up after implantation was 57.6 ± 33.6 months. The rate of VAO was 5.4%, the rate of glaucoma occurring after secondary implantation was 16.2%, and the rate of IOL exchange was 2.7%. The median visual acuity at final follow-up was 20/40. For patients with unilateral cataracts it was 20/60 and for bilateral patients it was 20/30. ConclusionsThe secondary IOL implantation in children is a relatively safe procedure associated with low rates of postoperative complications. Visual outcomes are acceptable and are better for bilateral patients than for unilateral patients.

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Section: Discussionsupporting

confidence: 65%

Secondary intraocular lens implantation following infantile cataract surgery: intraoperative indications, postoperative outcomes

Wood

Tadros

Trivedi

et al. 2016

Eye

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“…8 When sulcus foldable acrylic IOLs were studied in the pediatric population, lens decentration was found to be present in~5% of eyes. 9,10 In one study, 3 of 55 eyes had decentration, none of which needed surgery or were considered visually significant. 9 In another study, 4 of 77 eyes had decentration which required surgical repositioning or IOL exchange.…”

Section: Discussionmentioning

confidence: 99%

“…9,10 In one study, 3 of 55 eyes had decentration, none of which needed surgery or were considered visually significant. 9 In another study, 4 of 77 eyes had decentration which required surgical repositioning or IOL exchange. 10 Decentration was seen more in eyes with a longer AEL, postulated to be secondary to the disparity in the size of the IOL and the fixation site.…”

Section: Discussionmentioning

confidence: 99%

“…10 Decentration was seen more in eyes with a longer AEL, postulated to be secondary to the disparity in the size of the IOL and the fixation site. 9 Alternatives for sulcus IOLs are not plentiful, but include the Staar AQ2010 V, which has a 13.5 haptic loopto-loop dimension and rounded anterior optic edge. The AQ2010 V is silicone, however, which is not ideal in eyes which have often had vitreous loss during loss of posterior capsular support, leading to higher risk of retinal detachment and need for silicone oil later on.…”

Section: Discussionmentioning

confidence: 99%

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Stability and safety of MA50 intraocular lens placed in the sulcus

Kemp

Oetting

2015

Eye

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Purpose To describe the safety and stability of sulcus placement of the MA50 intraocular lens (IOL). Patients and methods Consecutive patients with MA50 IOLs placed in the sulcus at the University of Iowa Hospitals and Clinics, Iowa City, Iowa, USA, from 1997 to 2012 were identified. Inclusion criteria included patients with over 4 weeks of follow-up data. AEL was compared with incidence of IOL decentration using at two-tailed Student's t-test. Results Fifty eyes of 49 patients meeting the inclusion criteria were identified. Four weeks post-operatively, the average best-corrected visual acuity was 20/30. IOL decentration occurred in 14% of patients; patients with decentered IOLs had a significantly longer average AEL (25.37 mm) than patients whose IOL remained centered (23.94 mm, P = 0.017). Other complications included uveitisglaucoma-hyphema syndrome (12%), iritis (8%), and glaucoma (6%). There were no cases of pigment dispersion syndrome or need for lens exchange. Twelve eyes (24%) had intraoperative optic capture by the anterior capsule, none of which had post-operative decentration. Conclusion The MA50 IOL is a reasonable, stable option for placement in the sulcus, with a low-risk profile; however, in eyes with longer AEL and presumably larger anterior segment, surgeons should consider placing an IOL with longer haptic distance than the MA50 to maintain centration. Optic capture of the MA50 IOL by the anterior capsule should be considered for longer eyes, as it is protective against decentration.

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“…Böyle bir durumda siliyer sulkus yerleflimli G‹L implantasyonu en iyi seçenektir (5). Arka kapsülün tamamen intakt olmad›¤› durumlarda periferde kalan kapsül deste¤i de siliyer sulkusa lens yerlefltirilmesine olanak sa¤lamaktad›r (5,6). Kapsül deste¤inin yeterli ol-mad›¤› durumlarda ise, teknik zorlu¤u ve olas› kompli-kasyonlar› nedeniyle tart›flmal› olmakla birlikte skleral fiksasyonlu G‹L'leri kullan›lmaktad›r (7)(8)(9).…”

Section: Giriflunclassified

Secondary Intraocular Lens Implantation in Children with Aphakia

Yurdakul¹,

Maden²

2010

tjo

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ÖzetAmaç: Afak çocuklarda sekonder göz içi lens (G‹L) implantasyon sonuçlar›n› sunmak. Gereç ve Yöntem: fiubat 2001-Mart 2009 tarihleri aras›nda sekonder G‹L implantasyonu yap›lan çocukluk ça¤›ndaki afak olgular›n kay›tlar› geriye dönük olarak incelendi. Yüzeyel kornea skar› d›fl›nda ciddi patolojilere sahip travmatik olgular çal›flmaya al›nmad›. Olgular komplikasyonlar ve görme fonksiyonlar› aç›s›ndan de¤erlendirildi. Sonuçlar: Yirmi sekiz olgunun (11 erkek, 17 k›z) 38 gözü çal›flmaya al›nd›. Afak b›rak›lma nedenleri 11 gözde (%28,9) travmatik katarakt, 27 gözde (%71,1) konjenital katarakt idi. Arka kapsül deste¤i yeterli 15 gözde (%39,5) G‹L'i siliyer sulkusa implante edildi (Grup 1), kapsül deste¤i yetersiz 23 gözde (%60,5) skleral fiksasyonlu G‹L implantasyonu uygu-land› (Grup 2). Primer katarakt cerrahisi s›ras›ndaki yafl ortalamalar› Grup 1 olgular›nda 2,1±2,2 (0,5-8) y›l, Grup 2 olgu-lar›nda 6±5,7 (0,5-17,5) y›l idi (p=0,007). Sekonder G‹L implantasyonu s›ras›ndaki yafl ortalamalar› s›ras›yla 6,1±4,1 (3-17,5) y›l ve 10,4±5 (2,5-17,8) y›l idi (p=0,009). Sekonder G‹L implantasyonu sonras› Grup 1 olgular›n›n 2'sinde (%13,3) ve Grup 2 olgular›n›n 1'inde (%4,3) G‹L desantralizasyonu izlendi (p=0,550). Ayr›ca, Grup 2 olgular›n›n 4'ünde (%17,4) enflamasyon (p=0,013), 3'ünde (%13) pupilla düzensizli¤i (p=0,026) ve 2'sinde (%8,7) sütür erozyonu saptand› (p=0,509). Görme keskinli¤inde art›fl Grup 1 olgular›n›n %46,7'sinde ve Grup 2 olgular›n›n %56,5'inde elde edildi (p=0,741). Tart›flma: Afak çocuklar›n optik rehabilitasyonunda siliyer sulkus veya skleral fiksasyonla yap›lan sekonder G‹L implantasyonu etkili bir yöntemdir. Kesin bir sonuç için de¤iflik cerrahi tekniklerin karfl›laflt›r›ld›¤› daha genifl serilerde ve uzun izlem sürelerinde prospektif çal›flmalara gereksinim vard›r. (TJO 2010; 40: 295-9) Anahtar Kelimeler: Afaki, pediatrik katarakt, sekonder göz içi lens implantasyonu Summary Purpose: To report the results of secondary intraocular lens (IOL) implantation in children with aphakia. Material and Method: The records of children with aphakia who had secondary IOL implantation between February 2001 and March 2009 were reviewed retrospectively. Traumatic cases with serious pathology, except for superficial corneal scar, were not included in the study. The cases were evaluated in terms of complications and visual functions. Results: Thirty-eight eyes of 28 patients (11 male, 17 female) were included in the study. The causes of aphakia were traumatic cataract in 11 eyes (28.9%) and congenital cataract in 27 eyes (71.1%). In 15 eyes (39.5%) with adequate capsular support, IOL was placed in the ciliary sulcus (Group 1), whereas in 23 eyes (60.5%) without adequate capsular support, scleral fixated IOL implantation was performed (Group 2). The mean age at the time of primary cataract surgery was 2.1±2.2 (0.5-8) years in Group 1 and 6±5.7 (0.5-17.5) years in Group 2 (p=0.007). The mean age at the time of secondary IOL implantation was 6.1±4.1 (3-17.5) years and 10.4±5 (2.5-17.8) years in groups 1 and 2, respectiv...

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Secondary Intraocular Lens Implantation for Pediatric Aphakia

Cited by 46 publications

References 24 publications

Secondary intraocular lens implantation following infantile cataract surgery: intraoperative indications, postoperative outcomes

Secondary intraocular lens implantation following infantile cataract surgery: intraoperative indications, postoperative outcomes

Stability and safety of MA50 intraocular lens placed in the sulcus

Secondary Intraocular Lens Implantation in Children with Aphakia

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