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Abstract #26716 Published in IGR 12-3
Secondary IOL implantation in pediatric aphakia-in the bag versus sulcus implantation
Nihalani BR; VanderVeen DKJournal of AAPOS 2010; 14: 5
Purpose: To compare in-the-bag vs sulcus implantation of secondary IOL in pediatric eyes Material and Methods: Retrospective case review of patients with secondary IOL implantation between January 1999 to September 2009 for childhood aphakia. For in-the-bag (ITB) implantation, the anterior and posterior leaflets of capsule were separated with MVR blade and viscoelastic followed by removal of proliferative lens material. If the bag could not be opened adequately, then IOL was implanted in the sulcus, after removal of lens material within Sommering's ring. Sutured IOL cases were not included for this comparison. Results: 49 eyes of 32 patients (20 males) had secondary IOL implantation, with mean followup of 7.6 months. Mean age at primary surgery was 1.6 years; mean age at secondary IOL implantation was 8.8 years. 27 eyes had ITB and 22 had sulcus IOL. Forty-three eyes had Acrysof and 6 eyes had PMMA IOL. The prevalence of any corneal edema (45.5% vs 26%) and inflammation<2+ (91% vs 33.3%) in immediate postoperative period was higher with sulcus IOL vs. ITB. Mean absolute prediction error was 0.47 + 1.16 for sulcus IOL and 0.67 + 0.57. for in-the-bag IOL. Late inflammation developed in 1 eye and glaucoma developed in 2 eyes with sulcus IOL. No cases of significant IOL decentration were observed. No eye lost lines of vision. Conclusions: In-the-bag secondary IOL causes less inflammation and corneal edema in immediate postoperative period. Chronic inflammation and development of glaucoma were only observed in 2 eyes, both with sulcus implantation.
B.R. Nihalani.
Classification:
9.4.11.2 Glaucomas in aphakia and pseudophakia (Part of: 9 Clinical forms of glaucomas > 9.4 Glaucomas associated with other ocular and systemic disorders > 9.4.11 Glaucomas following intraocular surgery)
9.1.2 Juvenile glaucoma (Part of: 9 Clinical forms of glaucomas > 9.1 Developmental glaucomas)
