Glued Intrascleral Fixation of Posterior Chamber Intraocular Lens in Children

PURPOSE: To evaluate the short-term results of glued intrascleral fixation of posterior chamber intraocular lens (glued IOL) in children without adequate capsular support. DESIGN: Noncomparative retrospective observational case series. PATIENTS: SETTING: Institutional practice. METHODS: Forty-one eyes of 33 children who underwent glued IOL implantation were retrospectively evaluated. The indications were postsurgical aphakia, subluxated cataract, ectopia lentis, traumatic subluxation, and decentered IOL. MAIN OUTCOME MEASURES: Visual acuity (VA), endothelial cell changes, intraoperative and postoperative complications. RESULTS: The mean age at the time of glued IOL was 10.7 +/- 3.6 years (range 5-15). The mean duration of follow-up after surgery was 17.5 +/- 8.5 months (range 12-36). The mean postoperative best spectacle-corrected visual acuity (BCVA in decimal equivalent) was 0.43 +/- 0.33 and there was significant change noted (P < 0.001). Postoperatively, 20/20 and >20/60 BCVA was obtained in 17.1% and 46.3% of eyes respectively. BCVA improvement more than 1 line was seen in 22 eyes (53.6%). The mean postoperative refraction was myopic (-1.19 +/- 0.7 diopters [D]) in 19 eyes and hyperopic (+1.02 +/- 0.7 D) in 22 eyes. The mean endothelial loss was 4.13% (range 1.3%-5.94%). The 3 causes of reduced BCVA were the preexisting corneal, retinal pathology, and amblyopia. Postoperative complications included optic capture in 1 eye (2.4%), macular edema in 2 eyes (4.8%), and clinical decentration in 2 eyes (4.8%). There was no postoperative retinal detachment, IOL dislocation, endophthalmitis, or glaucoma. CONCLUSION: Short-term results in children after glued IOL were favorable, with a low rate of complications. However, regular follow-ups are required since long-term risks are unknown. (Am J Ophthalmol 2012;153:594-601. (C) 2012 by Elsevier Inc. All rights reserved.)