SCLERAL FIXATION OF POSTERIOR CHAMBER INTRAOCULAR LENSES IN CHILDREN

BACKGROUND AND OBJECTIVE: Children with monocular aphakia who become c ontact lens intolerant require an intraocular lens (IOL) for visual re habilitation. When there is inadequate support from the posterior lens capsule, use of an anterior chamber IOL or a sclerally fixated poster ior chamber IOL may be considered. The authors report their experience with scleral fixation of posterior chamber IOLs in children. PATIENTS AND METHODS: Seven posterior chamber IOLs were sutured in the ciliary sulcus of children who could not wear contact lenses. In each eye, th e lens capsule remnants were inadequate to provide sufficient support for the haptics of a posterior chamber lens. RESULTS: Six of seven pat ients had improved visual acuity, with an average improvement of 4 lin es. Complications related to scleral fixation included exposure of the scleral fixation suture in one eye, lens decentration in one eye, and lens tilt in one eye. Follow-up ranged from 3 to 38 months, averaging 26 months. CONCLUSION: Implantation of a posterior chamber sclerally fixated IOL offers an alternative to placement of an anterior chamber lens in children who cannot wear contact lenses and who lack capsular support. Continued follow-up of these patients will help determine the long-term safety of this technique.