Long Term Evaluation Of Correction Of Aphakia In Children Using A Modified Technique For Retropupillary Iris Supported Iol ( 7 Year Study)

To assess the efficacy, stability and safety of correction of aphakia in children using a modified technique for retropupillary iris supported iol

(long term follow up reach 7 years )

The Memorial Institute For Ophthalmic Research (MIOR)

 case series study of 20 eyes of 12 patients aged between 4-15 years. with follow up period ranges from 1 year  - 7 years.
 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

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 (shown in videos)

study included  12 patients, age ranged from 4 to 15 y .
  11 eyes (55%)  inadequate capsular support after cat surgery , 6 eyes (30%)  congenital lens subluxation  ,3 eyes (15%)  traumatic lens subluxation.

 100% of eyes showed improvement in UCVA, BCVA, stable IOL in their places .

pre-operative:
UCVA ranged from 0.01 to 0.05.
 BCVA ranged from 0.4 to 0.7.
 IOP ranged from 7 to 32 mmHg .
sphere (+6.00 to +10.0)

 postoperative:
 UCVA ranged from 0.3 to 0.7 .
BCVA ranged from 0.5 to 0.9 .
IOP ranged from 9 to 35 mmHg.
 sphere (+1.00 to + 2.00).

 complications:
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.

Retropupillary iris claw IOL is the best choice of correction of aphakia in children 

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