Intraocular Lens Tilt And Decentration In Secondary Ciliary Sulcus Implantation In Pediatric Eyes: A Three-Year Prospective Study

To compare the tilt and decentration of 1-piece anti-vaulting haptic intraocular lenses (IOL) and 3-piece C-loop haptic IOLs in pediatric eyes receiving secondary ciliary sulcus IOL implantation.

Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China.

In this prospective non-randomized interventional study, pediatric aphakic patients received 1-piece anti-vaulting haptic or 3-piece C-loop haptic IOLs implantation in ciliary sulcus were enrolled and followed for 3 years postoperatively. IOL decentration and tilt were measured using Scheimpflug images. Preoperative and postoperative information including demographic data, ocular biometric parameters and complications were also collected and analyzed.

Among 123 eyes of 79 pediatric patients, there were 72 eyes (58.54%) in the anti-vaulting haptic group, and 51 eyes (41.46%) in the C-loop haptic group. The anti-vaulting haptic group had lower incidence of clinically significant vertical IOL decentration than that in the C-loop haptic group (23.88% vs. 43.14%, P=0.037). No inter-group differences were detected in vertical and horizontal tilt, nor in horizontal decentration (all P>0.05). One-piece anti-vaulting haptic IOL was associated with lower risk of clinically significant vertical decentration compared with implantation of 3-piece C-loop haptic IOL (odds ratio: 0.42, P=0.037). There was a higher incidence of IOL dislocation in the C-loop haptic group (15.22% vs. 4.17%, P=0.046).

In pediatric aphakic eyes receiving secondary ciliary sulcus IOL implantation, 1-piece anti-vaulting haptic IOL can decrease risk of clinically significant IOL decentration and may benefit the long-term prognosis in terms of IOL positional stability.