Results of secondary ciliary sulcus fixated posterior chamber intra-ocular lenses in paediatric aphakia
Keywords:
Aphakia, Cataract, Ciliary sulcus fixation, Intra-ocular lens implantation
Abstract
Introduction: Primary Intraocular lens implantation is the most preferred method of paediatric cataract management. However there is little literature on secondary correction of aphakia with IOL implantation.
Objective: The objective of this study was to evaluate the safety and efficacy of ciliary sulcus implantation of posterior chamber IOLs in cases of paediatric aphakia.
Materials and Methods: The charts of 33 patients (52 eyes) ranging from 2-15 years of age, who underwent secondary implantation of PCIOL in the ciliary sulcus between 2016-17 were studied. Those cases that had sufficient capsular support after primary cataract extraction were included. Demographic data was obtained and correlated with the final outcomes in terms of refractive error, post op complications and visual outcome.
Results: The final mean visual acuity in log MAR was 0.64±0.42. 43% of eyes showed good visual acuity 0.4-0.6 log MAR. After surgery 85% patients with amblyopia showed good visual good response to occlusion therapy. Patients with aphakia operated for traumatic cataract achieved better visual acuity than those with congenital cataract (0.31±0.36 and 0.64±0.42 respectively). Mean difference of -0.06D was observed between targeted refraction and actual refraction.
Conclusions: Patients who had early primary cataract surgery showed better final visual acuity. Our observed complication rate showed that this method of aphakia correction is safe and effective.
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References
1. Zwaan J, Mullaney PB, Awad A, Al-Mesfer S, Wheeler DT. Pediatric intraocular lens implantation: surgical results and complications in more than 300 patients. Ophthalmol. 1998; 105 (1):112-9. DOI: https: //doi. org/10.1016/S0161-6420(98)91568-8
2. Trivedi RH, Wilson ME Jr, Facciani J. Secondary intraocular lens implantation for pediatric aphakia. J AAPOS. 2005;9(4):346-52.DOI:10.1016/j.jaapos. 2005. 02. 010
3. DeVARO JM, Buckley EG, Awner S, Seaber J. Secondary posterior chamber intraocular lens implantation in pediatric patients. Am J Ophthalmol. 1997; 123 (1): 24-30. DOI: 10.1016/s0002-9394(14) 70988-2
4. Biglan AW, Cheng KP, Davis JS, Gerontis CC. Secondary intraocular lens implantation after cataract surgery in children. Am J Ophthalmol 1997; 123: 224-34. DOI: https:// doi.org/10. 1016/ S0002-9394 (14)71040-2
5. Biglan AW, Cheng KP, Davis JS, Gerontis CC. Results following secondary intraocular lens implantation in children. Trans Am Ophthalmol Soc. 1996;94:353-73.
6. Brady KM, Atkinson CS, Kilty LA, Hiles DA. Cataract surgery and intraocular lens implantation in children. Am J Ophthalmol. 1995;120(1):1-9. DOI:10. 1016/ s0002-9394(14)73753-5
7. Awad AH, Mullaney PB, Al-Hamad A, Wheeler D, Al-Mesfer S, Zwaan J. J. Secondary posterior chamber intraocular lens implantation in children. J Am Assoc Pediat Ophthalmol Strab. 1998;2(5):269-74.
8. Mackool RJ, Russell RS. Intracapsular posterior chamber intraocular lens insertion with posterior capsular tears or zonular instability. J Cataract Refract Surg. 1995;21(4):376-7. DOI: https://doi.org/10. 1016/ S0886-3350(13)80523-8
9. Wilson ME, Bluestein EC, Wang XH. Current trends in the use of intraocular lenses in children. J Cataract Refract Surg. 1994;20(6):579-83. DOI: https://doi.org/ 10.1016/S0886-3350(13)80642-6
10. Lin AA, Buckley EG. Update on pediatric cataract surgery and intraocular lens implantation. Curr Opin Ophthalmol. 2010; 21(1): 55-9. DOI: 10.1097/ICU. 0b 013e 32833383cb.
11. Nihalani BR, Vasavada AR. Single-piece AcrySof intraocular lens implantation in children with congenital and developmental cataract. J Cataract Refract Surg. 2006;32(9):1527-34. DOI:10.1016/j. jcrs.2006.04. 021
12. Wilson ME, Trivedi RH. Choice of intraocular lens for pediatric cataract surgery: survey of AAPOS members. J Cataract Refract Surg. 2007;33(9):1666-8. DOI:10.1016/j.jcrs.2007.05.016
13. Khokhar SK, Pillay G, Agarwal E, Mahabir M. Innovations in pediatric cataract surgery. Indian J Ophthalmol. 2017;65 (3):210-216. DOI: 10.4103/ijo. IJO_860_16.
14. Hutchinson AK, Wilson ME, Saunders RA. Outcomes and ocular growth rates after intraocular lens implantation in the first 2 years of life. J Cataract Refract Surg. 1998;24(6):846-52. DOI: https://doi.org/ 10.1016/S0886-3350(98)80142-9
15. Agrawal R. Wound construction in small incision cataract surgery. Indian J Ophthalmol. 2010;58(1):85. DOI: 10.4103/0301-4738.58486
16. Autrata R, Rehurek J, Vodicková K. Visual results after primary intraocular lens implantation or contact lens correction for aphakia in the first year of age. Oph-thalmol.2005;219(2):72-9.DOI:10.1159/0000 83264
17. Birch EE, Stager DR. The critical period for surgical treatment of dense congenital unilateral cataract. Invest Ophthalmol Vis Sci. 1996;37(8):1532-8.
18. Shenoy BH, Mittal V, Gupta A, Sachdeva V, Kekunnaya R. Complications and visual outcomes after secondary intraocular lens implantation in children. Am J Ophthalmol. 2015;159(4):720-6. DOI: 10.1016/j. ajo. 2015. 01.002.
19. Beller R, Hoyt CS, Marg E, Odom JV. Good visual function after neonatal surgery for congenital monocular cataracts. Am J Ophthalmol. 1981;91 (5): 559-65. DOI:10.1016/0002-9394(81)90053-2
20. Gregg FM, Parks MM. Stereopsis after congenital monocular cataract extraction. Am J Ophthalmol. 1992; 114(3): 314-7. DOI: https://doi.org/ 10.1016/ S0002-9394 (14)71797-0
21. Bradford GM, Keech RV, Scott WE. Factors affecting visual outcome after surgery for bilateral congenital cataracts. Am J Ophthalmol. 1994;117 (1): 58-64. DOI:10.1016/s0002-9394(14)73015-6
22. De Ware IM, Buckley EG, Saeber J. Secondary posterior chamber intraocular lens implantation in paediatric patients, J Ophthalmol, 1997;123(1): 24-30. DOI: https://doi. org/10. 1016/ S0002-9394 (14)70988-2
23. Wiesel TN, Hubel DH. Single-cell responses in striate cortex of kittens deprived of vision in one eye. J Neurophysiol. 1963; 26 (6):1003-17.DOI: 10.1152/ jn. 1963. 26.6.1003
24. Garza-Reyes M, Rodríguez-Almaraz M, Ramírez-Ortíz MA. Long-term visual results in congenital cataract surgery associated with preoperative nystagmus. Arch Med Res. 2000;31(5):500-4. DOI: https:// doi. org/ 10.1016/S0188-4409(00)00101-6
25. Nihalani BR, Vanderveen DK. Secondary intraocular lens implantation after pediatric aphakia. J AAPOS. 2011; 15(5):435-40. DOI: 10.1016/j.jaapos. 2011.05.019.
26. Moore DB, Zion IB, Neely DE, Roberts GJ, Sprunger DT, Plager DA. Refractive outcomes with secondary intraocular lens implantation in children. J AAPOS. 2009; 13(6):551-4. DOI: 10.1016/j.jaapos. 2009. 09.012.
27. O'Keefe M, Fenton S, Lanigan B. Visual outcomes and complications of posterior chamber intraocular lens implantation in the first year of life. J Cataract Refract Surg. 2001;27(12):2006-11.DOI: https://doi.Org /10. 1016/S0886-3350(01)00973-7
28. Crinic T, Weakly DR Jr, Stager D Jr, Felius J. Use of Acrysol acrylic foldable intraocular lens for secondary implantation in children. J AAPOS 2004; 8(2):151-5. DOI: https://doi.org/10.1016/j.jaapos. 2003. 10. 005
29. Chen TC, Walton DS, Bhatia LS. Aphakic glaucoma after congenital cataract surgery. Arch Ophthalmol. 2004 Dec;122(12):1819-25. DOI:10.1001/ archopht. 122.12.1819
30. Michaelides M, Bunce C, Adams GG. Glaucoma following congenital cataract surgery--the role of early surgery and posterior capsulotomy. BMC Ophthalmol. 2007;7(1):13. DOI:10.1186/1471-2415-7-13
31. Chak M, Rahi JS. Incidence and factors associated with glaucoma after surgery for congenital cataract: Findings from the British Congental Cataract Study. Ophthalmol. 2008;115(6):1013-18. DOI: 10.1016/j. ophtha.2007.09.002
32. Wood KS, Tadros D, Trivedi RH, Wilson ME. Secondary intraocular lens implantation following infantile cataract surgery: intraoperative indications, post operative complications. Eye 2016;30(9):1182-1186. DOI: 10.1038/eye.2016.131
33. Hiles DA, Watson BA. Complications of implant surgery in children. J Am Intraocul Implant Soc. 1979; 5(1):24-32.
2. Trivedi RH, Wilson ME Jr, Facciani J. Secondary intraocular lens implantation for pediatric aphakia. J AAPOS. 2005;9(4):346-52.DOI:10.1016/j.jaapos. 2005. 02. 010
3. DeVARO JM, Buckley EG, Awner S, Seaber J. Secondary posterior chamber intraocular lens implantation in pediatric patients. Am J Ophthalmol. 1997; 123 (1): 24-30. DOI: 10.1016/s0002-9394(14) 70988-2
4. Biglan AW, Cheng KP, Davis JS, Gerontis CC. Secondary intraocular lens implantation after cataract surgery in children. Am J Ophthalmol 1997; 123: 224-34. DOI: https:// doi.org/10. 1016/ S0002-9394 (14)71040-2
5. Biglan AW, Cheng KP, Davis JS, Gerontis CC. Results following secondary intraocular lens implantation in children. Trans Am Ophthalmol Soc. 1996;94:353-73.
6. Brady KM, Atkinson CS, Kilty LA, Hiles DA. Cataract surgery and intraocular lens implantation in children. Am J Ophthalmol. 1995;120(1):1-9. DOI:10. 1016/ s0002-9394(14)73753-5
7. Awad AH, Mullaney PB, Al-Hamad A, Wheeler D, Al-Mesfer S, Zwaan J. J. Secondary posterior chamber intraocular lens implantation in children. J Am Assoc Pediat Ophthalmol Strab. 1998;2(5):269-74.
8. Mackool RJ, Russell RS. Intracapsular posterior chamber intraocular lens insertion with posterior capsular tears or zonular instability. J Cataract Refract Surg. 1995;21(4):376-7. DOI: https://doi.org/10. 1016/ S0886-3350(13)80523-8
9. Wilson ME, Bluestein EC, Wang XH. Current trends in the use of intraocular lenses in children. J Cataract Refract Surg. 1994;20(6):579-83. DOI: https://doi.org/ 10.1016/S0886-3350(13)80642-6
10. Lin AA, Buckley EG. Update on pediatric cataract surgery and intraocular lens implantation. Curr Opin Ophthalmol. 2010; 21(1): 55-9. DOI: 10.1097/ICU. 0b 013e 32833383cb.
11. Nihalani BR, Vasavada AR. Single-piece AcrySof intraocular lens implantation in children with congenital and developmental cataract. J Cataract Refract Surg. 2006;32(9):1527-34. DOI:10.1016/j. jcrs.2006.04. 021
12. Wilson ME, Trivedi RH. Choice of intraocular lens for pediatric cataract surgery: survey of AAPOS members. J Cataract Refract Surg. 2007;33(9):1666-8. DOI:10.1016/j.jcrs.2007.05.016
13. Khokhar SK, Pillay G, Agarwal E, Mahabir M. Innovations in pediatric cataract surgery. Indian J Ophthalmol. 2017;65 (3):210-216. DOI: 10.4103/ijo. IJO_860_16.
14. Hutchinson AK, Wilson ME, Saunders RA. Outcomes and ocular growth rates after intraocular lens implantation in the first 2 years of life. J Cataract Refract Surg. 1998;24(6):846-52. DOI: https://doi.org/ 10.1016/S0886-3350(98)80142-9
15. Agrawal R. Wound construction in small incision cataract surgery. Indian J Ophthalmol. 2010;58(1):85. DOI: 10.4103/0301-4738.58486
16. Autrata R, Rehurek J, Vodicková K. Visual results after primary intraocular lens implantation or contact lens correction for aphakia in the first year of age. Oph-thalmol.2005;219(2):72-9.DOI:10.1159/0000 83264
17. Birch EE, Stager DR. The critical period for surgical treatment of dense congenital unilateral cataract. Invest Ophthalmol Vis Sci. 1996;37(8):1532-8.
18. Shenoy BH, Mittal V, Gupta A, Sachdeva V, Kekunnaya R. Complications and visual outcomes after secondary intraocular lens implantation in children. Am J Ophthalmol. 2015;159(4):720-6. DOI: 10.1016/j. ajo. 2015. 01.002.
19. Beller R, Hoyt CS, Marg E, Odom JV. Good visual function after neonatal surgery for congenital monocular cataracts. Am J Ophthalmol. 1981;91 (5): 559-65. DOI:10.1016/0002-9394(81)90053-2
20. Gregg FM, Parks MM. Stereopsis after congenital monocular cataract extraction. Am J Ophthalmol. 1992; 114(3): 314-7. DOI: https://doi.org/ 10.1016/ S0002-9394 (14)71797-0
21. Bradford GM, Keech RV, Scott WE. Factors affecting visual outcome after surgery for bilateral congenital cataracts. Am J Ophthalmol. 1994;117 (1): 58-64. DOI:10.1016/s0002-9394(14)73015-6
22. De Ware IM, Buckley EG, Saeber J. Secondary posterior chamber intraocular lens implantation in paediatric patients, J Ophthalmol, 1997;123(1): 24-30. DOI: https://doi. org/10. 1016/ S0002-9394 (14)70988-2
23. Wiesel TN, Hubel DH. Single-cell responses in striate cortex of kittens deprived of vision in one eye. J Neurophysiol. 1963; 26 (6):1003-17.DOI: 10.1152/ jn. 1963. 26.6.1003
24. Garza-Reyes M, Rodríguez-Almaraz M, Ramírez-Ortíz MA. Long-term visual results in congenital cataract surgery associated with preoperative nystagmus. Arch Med Res. 2000;31(5):500-4. DOI: https:// doi. org/ 10.1016/S0188-4409(00)00101-6
25. Nihalani BR, Vanderveen DK. Secondary intraocular lens implantation after pediatric aphakia. J AAPOS. 2011; 15(5):435-40. DOI: 10.1016/j.jaapos. 2011.05.019.
26. Moore DB, Zion IB, Neely DE, Roberts GJ, Sprunger DT, Plager DA. Refractive outcomes with secondary intraocular lens implantation in children. J AAPOS. 2009; 13(6):551-4. DOI: 10.1016/j.jaapos. 2009. 09.012.
27. O'Keefe M, Fenton S, Lanigan B. Visual outcomes and complications of posterior chamber intraocular lens implantation in the first year of life. J Cataract Refract Surg. 2001;27(12):2006-11.DOI: https://doi.Org /10. 1016/S0886-3350(01)00973-7
28. Crinic T, Weakly DR Jr, Stager D Jr, Felius J. Use of Acrysol acrylic foldable intraocular lens for secondary implantation in children. J AAPOS 2004; 8(2):151-5. DOI: https://doi.org/10.1016/j.jaapos. 2003. 10. 005
29. Chen TC, Walton DS, Bhatia LS. Aphakic glaucoma after congenital cataract surgery. Arch Ophthalmol. 2004 Dec;122(12):1819-25. DOI:10.1001/ archopht. 122.12.1819
30. Michaelides M, Bunce C, Adams GG. Glaucoma following congenital cataract surgery--the role of early surgery and posterior capsulotomy. BMC Ophthalmol. 2007;7(1):13. DOI:10.1186/1471-2415-7-13
31. Chak M, Rahi JS. Incidence and factors associated with glaucoma after surgery for congenital cataract: Findings from the British Congental Cataract Study. Ophthalmol. 2008;115(6):1013-18. DOI: 10.1016/j. ophtha.2007.09.002
32. Wood KS, Tadros D, Trivedi RH, Wilson ME. Secondary intraocular lens implantation following infantile cataract surgery: intraoperative indications, post operative complications. Eye 2016;30(9):1182-1186. DOI: 10.1038/eye.2016.131
33. Hiles DA, Watson BA. Complications of implant surgery in children. J Am Intraocul Implant Soc. 1979; 5(1):24-32.
CITATION
DOI: 10.17511/jooo.2019.i03.01
Published: 2019-10-19
How to Cite
Faruqui, S., Khan, M. S., & Jain, R. (2019). Results of secondary ciliary sulcus fixated posterior chamber intra-ocular lenses in paediatric aphakia. Tropical Journal of Ophthalmology and Otolaryngology, 4(3), 181-189. https://doi.org/10.17511/jooo.2019.i03.01
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