Scleral-Fixed Intraocular Lens Using Gore-Tex Sutures In Children With Absent Capsular Support

To evaluate visual, refractive, endothelial, and safety outcomes of Gore-Tex–sutured scleral-fixated intraocular lens implantation in pediatric eyes lacking capsular support.

Single-center study conducted at King Abdullah Specialized Children's Hospital, Riyadh, Saudi Arabia.

This prospective interventional case series included pediatric patients (1–14 years) with lens dislocation or aphakia without capsular support undergoing primary or secondary Gore-Tex–sutured scleral-fixated intraocular lens implantation. Primary outcomes were visual acuity, refractive error, endothelial cell count, and intraocular pressure. Secondary outcomes included IOL tilt, pupillary capture, suture-related complications, uveitis, corneal edema, and retinal detachment. Patients with follow-up <6 months were excluded.

This study included 7 eyes of 6 patients (mean age 9.5 ± 3.1 years; mean follow-up 11 ± 5.2 months). Lens dislocation occurred in four patients (Marfan n=2, homocystinuria n=2); one traumatic and one congenital cataract were included. Visual acuity improved from 0.42 ± 0.36 to 0.15 ± 0.13 logMAR. Spherical equivalent shifted from −3.42 ± 0.91 to 1.14 ± 0.50 D. Endothelial cell count decreased from 3226.6 ± 70.2 to 3141.3 ± 39.6 cells/mm² (2.6% loss; p=0.002), not clinically significant. Complications included elevated IOP (Ahmed valve), IOL tilt (repositioned), and IOL capture (medical treatment). No uveitis, corneal edema, retinal detachment, or suture complications were observed.

Gore-Tex–sutured scleral-fixated IOL implantation in pediatric eyes provided favorable visual and refractive outcomes with minimal endothelial cell loss and acceptable safety. Complications were limited and manageable, with no vision-threatening events observed during follow-up.