EVALUATION OF CORRECTION OF APHAKIA IN CHILDREN USING A MODIFIED TECHNIQUE FOR RETROPUPILLARY IRIS SUPPORTED IOL

 The inclusion criteria were aphakia with insufficient capsular or zonular support, sufficient iris tissue , no history of uveitis.

Excluison Criteria : presence of capsularsupport , aniridia, sever iris atrophy or iris laceration that cannot be repaired

PreOperative :full ophthalmic examination specially BCVA and absence of capsular support and presence of iris support.

post operative: follow up the stability of the iol in its place , areas of iris atrophy and refraction of the patient .

Surgical Technique : This modified technique depending on that while I am fixating the claw in the iris ,I perforate the iris with one side of the claw to keep one side of each claw anterior to the iris, this will be more safe especially for children that this will prevent the IOL from dropping in vitreous with trauma or with iris atrophy ( this technique showed in the videos of surgeries).

study included  12 patients; 9  males and 3  females. Their age ranged from 4 to 15 y with mean age of 6.73 ± 5.22 years.

  indications of surgery: 11 eyes (55%)  inadequate capsular support after cataract surgery , 6 eyes (30%)  congenital lens subluxation  ,3 eyeS (15%) had traumatic lens subluxation.

 100% of eyes showed improvement in UCVA, BCVA, stable IOL in their places (no dropped iol ,no decentered iol, no dislocted iol).

The preop. UCVA ranged from 0.01 to 0.05, with a mean of 0.025 ± 0.028. The preop. BCVA ranged from 0.4 to 0.7, with a mean of 0.62 ± 0.071. The preoperative IOP ranged from 7 to 32 mmHg with a mean of 15.26 ± 5.11 mmHg.

The postoperative data were as follows: the UCVA ranged from 0.3 to 0.7, with a mean of 0.46 ± 0.082 which differed significantly from preoperative UCVA (p <0.001). The postoperative best-corrected visual acuity (BCVA) ranged from 0.5 to 0.9, with a mean of 0.86 ± 0.13 which differed significantly from preoperative BCVA (p <0.001). The postoperative intraocular pressure (IOP) ranged from 9 to 35 mmHg with a mean of 18.31 ± 8.39 mmHg.

Pre-operative sphere (+6.00 to +10.0) that significant changed post-operatively to (+1.00 to + 2.00).

 postoperative complications, during the early postoperative period, three (15%) eyes showed mild corneal edema, two (10%) eyes had transient IOP elevation more than 20 mmHg and one (5%) eye had AC inflammatory reaction.

 This modification I did in the original technique will make the use of this IOL more safe  in children even if iris atrophy occured or trauma to the eye , the part of iol in front of the iris tissue will prevent iol from dropped in the viterous.