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Secondary scleral fixation posterior chamber intraocular lens with versus without conjunctival dissection for unilateral aphakia in the pediatric population

Poster Details

First Author: M.Diaab SEYCHELLES

Co Author(s):    S. Eissa   A. Samir           

Abstract Details

Purpose:

Optical rehabilitation of unilateral aphakia in eyes with no capsular support is problematic in pediatric patients who cannot tolerate contact lenses. Possible options include a unilateral aphakic spectacle, an anterior chamber intraocular lens (IOL), or a scleral fixated posterior chamber IOL. Of these choices the posterior chamber IOL is the most physiologic purpose of our study is to compare sulcus-fixated IOLs supported by capsular remnants versus scleral fixation posterior chamber intraocular lens with or without conjunctival dissection in the pediatric population.

Setting:

Magrabi Hospital Damam, KSA

Methods:

36 unilateral aphakic children 2–16 years old with intolerant of contact lenses and whose anterior segments lack capsular support. Subdivided to two groups. Group A children subjected to Scleral fixation of intraocular lenses with traditional Passage of a double-armed suture through the roof of the scleral tunnel with subsequent retrieval of the suture ends through the external incision for tying facilitates scleral fixation. Group B subjected to Scleral fixation of intraocular lenses with scleral pocket initiated through a peripheral clear corneal incision without conjunctival dissection Amblyopia therapy in the form of patching was given post-IOLsurgery.The follow-up ranged from 7 to 12 months.

Results:

Postoperative best-corrected visual acuity (BCVA) in comparison to preoperative visual status and complications from the procedure were analyzed Postoperative Amblyopia and visual acuity improved in all patients in the two groups, with no statistical significant difference. Refractive goals were achieved in all but two patients in group A and one patient in group B suffered elevated intraocular pressure, two patients in group A showed anterior uveitis and one case in group B revealed mild IOL decenteration and suture erosion through the conjunctiva in two eyes in group A.

Conclusions:

Although short-term visual results appear encouraging in scleral fixation IOLs but this procedure is technically more difficult and has an increased incidence of postoperative complications when compared with secondary sulcus-fixated IOLs supported by capsular remnants. Group B showing privilege of eliminates the need for conjunctival dissection and scleral cauterization with no chance for suture erosion through the conjunctiva Further study with a larger patient sample and longer follow-up is recommended to document visual acuity and any further complications.

Financial Disclosure:

NONE

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