Posterior Iris-claw Aphakic Intraocular Lens Implantation in Children

PURPOSE: To evaluate the indications, visual outcomes, and complication rate after posterior implantation of an iris-claw aphakic intraocular lens (IOL) in children. DESIGN: Noncomparative retrospective cohort study. METHODS: SETTING: Institutional practice. PATIENTS/INTERVENTION PROCEDURES: Seven eyes of 4 children without adequate capsular support had posterior chamber iris-claw aphakic IOL implantation between 2007 and 2012. MAIN OUTCOME MEASURES: Visual acuity, endothelial cell changes, intraoperative and postoperative complications. RESULTS: The mean age of the 3 boys and 1 girl was 12.0 +/- 3.4 (SD) years (range 8-16 years). In all eyes, the mean postoperative best spectacle-corrected visual acuity (0.13 +/- 0.17 logMAR) was statistically significantly better at the last follow-up than at 1 day preoperatively (0.60 +/- 0.39 logMAR) (P < .05). The mean follow-up was 31 months (range 10-64 months). The mean endothelial cell density decreased from 3013 155 cells/mm(2) preoperatively to 2831 +/- 236 cells/mm(2) at last follow-up, representing a mean endothelial cell loss of 6.4%. No corneal decompensation, iritis, secondary glaucoma, or pupillary block occurred after surgery in any eye. Postoperative complications included transient postoperative hypotony in 1 eye and a traumatic dislocation of a posterior aphakic iris-claw IOL in 1 eye. CONCLUSION: The posterior implantation technique of aphakic iris-claw IOL provided good visual outcomes with a favorable complication rate and can be used as a reasonable alternative for a wide range of indications in pediatric eyes without adequate capsular support. ((C) 2013 by Elsevier Inc. All rights reserved.)