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

Abstract

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.

Clinical Outcomes of Endoscope-Assisted 30-Gauge Single-Needle Technique for Intrascleral Intraocular Lens Fixation

“…If the puncture site has greatly deviated from the ciliary sulcus, the 30-G needle was re-punctured so as to permit its insertion into the vicinity of the ciliary sulcus. The endoscope also has been used for precise direct examination and trimming of the vitreous at the 30-G scleral puncture site and peripheral retina, which may decrease the risk of postoperative retinal detachment [11].…”

Ophthalmic endoscope: A novel diagnostic imaging tool

“…Another study on use of endoscope in scleral fixation of posterior chamber intraocular lens in pediatric age group suggests that endoscopic-assisted sclera fixation in children is a safe and effective technique that may reduce surgical complications in transscleral sulcus suturing of IOLs and helps the surgeon identify precisely the haptic positions, which may reduce the incidence of iris root and ciliary body damage. [34] Needle penetration under direct vision by the aid of the endoscope also facilitates proper trimming of any vitreous bands at the haptic sites intraoperatively. Ophthalmic micro-endoscope also allows proper examination of the retinal periphery, that might help in lowering the rates of retinal complications like missed peripheral retinal tears.…”

Skleraya sabitlenen göz içi lensi uygulama teknikleri

“…18-gauge bir mikroendoskopa 16-gauge silikon bir tüple birleştirilen 10-0 polipropilen sütür kontrollü bir şekilde sulkustan geçirilebilir [28]. Bu tekniğin afak çocuklarda da başarılı bir şekilde kullanıldığı bildirilmiştir [29].…”