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2016 ; 30
(9
): 1155-9
Nephropedia Template TP
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Is an iris claw IOL a good option for correcting surgically induced aphakia in
children? A review of the literature and illustrative case study
#MMPMID27391934
Barbara R
; Rufai SR
; Tan N
; Self JE
Eye (Lond)
2016[Sep]; 30
(9
): 1155-9
PMID27391934
show ga
Refractive correction of aphakia in childhood can be a complex management issue
following lensectomy for congenital cataract or ectopia lentis. Some children
have inadequate capsular support to allow an 'in the bag' or sulcus fixated
intra-ocular lens (IOL). In such cases, options for refractive correction include
spectacles, contact lenses, or surgically fixed IOLs. Many methods of IOL
fixation have been described, but none are widely adopted in children. In recent
years, the iris-fixated Artisan Aphakic IOL has gained popularity, but there is
still significant concern about the rate of corneal endothelial cell loss and IOL
de-enclavation. Here, we review the current literature on the use of iris-fixated
IOLs in children, the published data on endothelial cell loss and de-enclavation
rates. We present a case illustrating the significant improvements in quality of
life, which can be seen in selected children, and also the rate of endothelial
cell loss, which can be encountered after initial surgery, and a re-enclavation
event. We make the case that until more data are available on normal endothelial
cell decline in early childhood, in addition to age-specific rates of endothelial
cell loss and de-enclavation rates following surgery, the use of iris-fixated
IOLs in children will continue to be a moot point and is unlikely to be widely
adopted.