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Is it better to implant an IOL in the sulcus or leave the baby aphakic regarding glaucoma development?

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Session Details

Session Title: Congenital Cataract Surgery

Session Date/Time: Sunday 14/09/2014 | 16:30-18:30

Paper Time: 17:39

Venue: Boulevard A

First Author: : M.Tekavcic Pompe SLOVENIA

Co Author(s): :    V. Pfeifer              

Abstract Details


to compare secondary glaucoma rate in eyes operated on in the first year of life due to congenital cataract with primary IOL implantation (sulcus vs. bag) or without it.


Eye Hospital, University Clinical Centre Ljubljana, Slovenia


30 children with unilateral (20) or bilateral (10) congenital cataract were included in this retrospective case review study, 40 affected eyes were studied. Inclusion criteria were: cataract surgery in the first 12 months of life and at least 1 year of follow-up. In the majority of eyes (34) IOL was primarily implanted, in 24 in the bag with optic capture and in 10 in the sulcus with optic capture, 6 eyes were left afakic. Basic surgical technique was similar in all eyes and consisted of anterior CCC, cataract aspiration, posterior CCC and anterior vitrectomy. Optimal surgical result was achieved if IOL was implanted in the bag with optic capture, however due to structural handicap of these eyes in the bag IOL implantation was not always possible. Presence or absence of secondary glaucoma was recorded at each visit during the follow-up period.


Overall glaucoma rate in this study was 42% and was lowest in the eyes with in the bag IOL implantation (18%) and highest in the afakic eyes (100%). The eyes with IOL implanted in the sulcus showed 55% secondary glaucoma rate. In all afakic eyes glaucoma developed within the first 12 post-op months.


In this study afakic eyes showed highest secondary glaucoma rate, however these eyes were structurally most handicapped (short, microphthalmic eyes often with extreme PFV) which is probably also a major risk factor.

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