Iris fixation of foldable intraocular lenses for ectopia lentis in children

Abstract

The results suggest that iris fixation of foldable IOLs for ectopia lentis in children can lead to good anatomical and functional results. The use of the remaining part of the sulcus is helpful in reaching correct positioning of the IOL. The complication rate is similar to that with other techniques described in the literature, whereas the small incision and the absence of transscleral sutures could simplify the short-term and long-term evolution.

Iris-sutured intraocular lenses for ectopia lentis in children

“…10,18,21,22,[28][29][30] Irissutured IOLs avoid several of these complications. Our results and those of Dureau et al 7 and Condon et al 26 show that iris-sutured IOLs can yield excellent visual outcomes that are at least as good as those obtained by optically correcting aphakia with spectacles or contact lenses.…”

“…This is in contrast to results in a recent study of 17 eyes of 9 patients who had limbal lensectomy with insertion of a foldable iris-sutured IOL for ectopia lentis in which there were no instances of IOL dislocation within a mean 16.3 months of follow-up. 7 In that study, the portions of the capsule where there had been adequate zonular support were not removed. In all the other series in Table 1, the capsule was removed.…”

“…3 In recent years, there has been mounting evidence that lensectomy, whether through the limbal or pars plana approach, combined with anterior vitrectomy is safe in the longer term. [4][5][6][7][8][9][10][11][12][13][14][15][16][17][18] Bilaterally aphakic children can be managed with spectacles or contact lenses and unilaterally aphakic children can be managed with contact lenses with excellent visual outcomes; however, aphakic spectacles produce troublesome optical aberrations and a limited visual field, may be considered disfiguring, and may cause the patient to have difficulty integrating into the social environment. 10 Contact lenses, on the other hand, have been associated with intolerance, noncompliance, need for frequent replacement, and relatively high costs.…”

“…20 Therefore, an increasing number of surgeons have attempted IOL insertion after lensectomy in patients with ectopia lentis. 7,[10][11][12]18,21,22 Intraocular lenses can be implanted in the anterior chamber (open-loop anterior chamber IOLs or Artisan foldable IOLs enclavated onto the iris) 11,12 or in the posterior chamber using transscleral fixation 10,18,21,22 or, more recently, iris-suture fixation. 7 We sought to compare visual outcomes and complications after pars plana lensectomy-vitrectomy (PPL-PPV) for ectopia lentis between pediatric patients who were left aphakic and managed with contact lenses or aphakic spectacles and those in whom an iris-sutured foldable IOL was implanted.…”

Intraoperative performance and postoperative outcomes of endocapsular ring implantation in pediatric eyes

“…However, there were no cases of visual axis obscuration, secondary glaucoma, or retinal complications. Lam et al 25 also report scleral fixation of an IOL in young eyes with subluxated lenses, and Dureau et al 26 report iris fixation of foldable IOLs as an alternative technique in children. Dureau et al suggest this technique can maintain well-centered IOLs and round pupils.…”