Evaluation of functional outcome and stability of sutureless scleral tunnel fixated IOLs in children with ectopia lentis

Abstract:

AIM: To evaluate functional outcome of sutureless scleral tunnel intraocular lens (SSTIOL) in children with crystalline lens subluxation of more than 7 clock hours. METHODS: A prospective interventional study was conducted consisting of 45 eyes of 44 children in age group 6-18y having >7 clock hours of lens subluxation who underwent lensectomy-vitrectomy followed by SSTIOL implantation. Primary outcome was improvement in best corrected visual acuity (BCVA) and secondary outcomes were assessment of intraocular lens (IOL) tilt using ultrasound biomicroscopy (UBM), mean change in astigmatism at last follow-up of 1y and associated complications. RESULTS: The mean preoperative and postoperative BCVA was 1.05±0.28 and 0.64±0.45 (logMAR) respectively (P=0.001) at last follow-up. The mean astigmatism preoperatively and postoperatively was -4.17±2.69 D and -1.86±1.25 D respectively (P=0.011). Significant IOL tilt (>5 degrees) was present in 5 cases. The mean percentage endothelial loss was 3.65%±1.92%. The most serious complication encountered was retinal detachment seen in 2 cases. CONCLUSION: SSTIOL implantation provides efficient visual rehabilitation in children provided there is stringent case selection. We recommend caution in children having white-to-white distance >12 mm and presence of peripheral retinal degenerations.