Purpose:

To report the results of secondary intraocular lens (IOL) implantation in children with aphakia.

Material and Method:

The records of children with aphakia who had secondary IOL implantation between February 2001 and March 2009 were reviewed retrospectively. Traumatic cases with serious pathology, except for superficial corneal scar, were not included in the study. The cases were evaluated in terms of complications and visual functions.

Results:

Thirty-eight eyes of 28 patients (11 male, 17 female) were included in the study. The causes of aphakia were traumatic cataract in 11 eyes (28.9%) and congenital cataract in 27 eyes (71.1%). In 15 eyes (39.5%) with adequate capsular support, IOL was placed in the ciliary sulcus (Group 1), whereas in 23 eyes (60.5%) without adequate capsular support, scleral fixated IOL implantation was performed (Group 2). The mean age at the time of primary cataract surgery was 2.1±2.2 (0.5-8) years in Group 1 and 6±5.7 (0.5-17.5) years in Group 2 (p=0.007). The mean age at the time of secondary IOL implantation was 6.1±4.1 (3-17.5) years and 10.4±5 (2.5-17.8) years in groups 1 and 2, respectively (p=0.009). After secondary IOL implantation, IOL decentration was detected in 2 (13.3%) cases of Group 1, and in 1 (4.3%) case of Group 2 (p=0.550). Moreover, inflammation in 4 (17.4%) (p=0.013), pupillary irregularity in 3 (3%) (p=0.026), and suture erosion in 2 (8.7%) (p=0.509) cases of Group 2 were observed. Visual acuity improvement was obtained in 46.7% of Group 1 cases and in 56.5% of Group 2 cases (p=0.741).

Discussion:

Secondary IOL implantation with either ciliary sulcus or scleral fixation is an effective procedure for optical rehabilitation in children with aphakia. To make a definite conclusion, prospective studies comparing different surgical techniques in larger series and with longer follow-up periods are needed.

Keywords: Aphakia, pediatric cataract, secondary intraocular lens implantation