Transsclerally fixated intraocular artificial lenses in children – analysis of long-term postoperative complications

Purpose
To report the long–term surgical complications of transscleral sutured intraocular lens implantation in children.

Material and methods
Surgical procedure was performed in 10 children (17 eyes) with ectopia lentis, and in 16 children (21eyes) with aphakia between July 1995 and December 1998. The mean age of implantation was 8.1 years ( range 4 to 17). The Lewis method ab externo was used to suture 1–piece PMMA IOL in all cases. Average follow–up was 9.1 years (range 8 to 11 years).

Results
After operation in long time observations, we noted retinal detachment in 1 eye (post trauma), suture break and IOL dislocation in 3 eyes, suture erosion through the scleral flap in 4 eyes, suture erosion through the flap and conjuctiva in 2 eyes, IOL decentraction in 3 eyes, IOL tilt in 6 eyes, glaucoma in 2 eyes, anterior uveitis in 2 eyes. Four eyes exhibited episodes of iris capture of the IOL optic. There were no endophthalmitis in this group of patients.

Conclusions
The analysis showed that long follow up and complications was associated with scleral fixation included exposure of the scleral suture and the suture break, not with retinal detachment and endophthalmitis.