Visual results and postoperative complications of capsular bag and ciliarysulcus fixation of posterior chamber intraocular lenses in children with traumatic cataracts

Purpose: To evaluate the visual results and postoperative complications of capsular bag and ciliary sulcus fixation of posterior chamber intraocular l enses (IOLs) for traumatic cataracts in children. Setting: Department of Ophthalmology, Postgraduate Institute of Medical Edu cation and Research, Chandigarh, India. Methods: Twenty children (20 eyes) with traumatic cataracts had extracapsul ar cataract extraction (ECCE) and posterior chamber IOL implantation. They were randomly divided into 2 groups. Capsular bag fixation was performed in 10 children (Group A) and ciliary sulcus fixation in the other 10 (Group B ); Traumatic cataracts with large corneal lacerations (10.0 mm or more), hy phema, angle recession, or posterior segment involvement were excluded. The best corrected acuity (BCVA) as well as early and delayed postoperative co mplications were prospectively evaluated in both groups. Results: The BCVA was 6/12 or better in 9 eyes (90%) in Group A and 8 eyes (80%) in Group B at the end of the mean follow-up (24.6 months +/- 10.6 [SD ]). Amblyopia (1 eye in Group A) and corneal scar and commotio retinae (1 e ye each in Group B) accounted for a visual acuity of worse than 6/12. The r esidual refractive error did not exceed 3.50 diopters in either group. The incidences of fibrinous anterior uveitis and pupillary capture were signifi cantly higher in Group B (P <.05, Fisher exact test). Conclusion: Capsular bag fixation of posterior chamber IOLs provided visual results similar tot hose with ciliary sulcus fixation but was associated w ith fewer postoperative complications, particularly uveitis and pupillary c apture. This represents another important reason to attempt in-the-bag fixa tion in cases of traumatic cataract J Cataract Refract Surg 1999, 25:1576-1 584 (C) 1999 ASCRS and ESCRS.