Scleral fixation of posterior chamber intraocular lenses in children

Abstract

Background and objective: Children with monocular aphakia who become contact lens intolerant require an intraocular lens (IOL) for visual rehabilitation. When there is inadequate support from the posterior lens capsule, use of an anterior chamber IOL or a sclerally fixated posterior chamber IOL may be considered. The authors report their experience with scleral fixation of posterior chamber IOLs in children.

Patients and methods: Seven posterior chamber IOLs were sutured in the ciliary sulcus of children who could not wear contact lenses. In each eye, the lens capsule remnants were inadequate to provide sufficient support for the haptics of a posterior chamber lens.

Results: Six of seven patients had improved visual acuity, with an average improvement of 4 lines. Complications related to scleral fixation included exposure of the scleral fixation suture in one eye, lens decentration in one eye, and lens tilt in one eye. Follow-up ranged from 3 to 38 months, averaging 26 months.

Conclusion: Implantation of a posterior chamber sclerally fixated IOL offers an alternative to placement of an anterior chamber lens in children who cannot wear contact lenses and who lack capsular support. Continued follow-up of these patients will help determine the long-term safety of this technique.