Surgical outcomes and complications of sutured scleral fixated intraocular lenses in pediatric eyes

Objective: To study the outcome and complications of sutured scleral fixated intraocular lenses (SSFIOL) in children. Design: Retrospective study. Subjects: A total of 279 eyes of 230 children who underwent SSFIOL at ≤18 years of age in a tertiary eye care centre in India. Methods: Treatment-naive children having traumatic cataract or subluxated lens underwent a single-sitting lensectomy and pars plana vitrectomy (PPV), along with SSFIOL insertion. Children with aphakia underwent PPV with SSFIOL, and vitrectomized eyes underwent only SSFIOL implantation. Fixation of SSFIOL was done by the 4-point ab externo fixation technique using 10-0 prolene suture. Main outcome measures: Preoperative and postoperative visual acuity, as well as intraoperative and postoperative complications. Results: The mean age at which SSFIOL was performed was 10.8 ± 4.22 years. The most common indication of SSFIOL in our study was traumatic subluxation of lens (47.63%; n = 133 patients), followed by congenital subluxation in 38.7% (n = 108). Best-corrected visual acuity was maintained or improved from the preoperative visual acuity in 93.19% of eyes. The complications included choroidal detachment in 2.86% (n = 8), dispersed vitreous hemorrhage in 2.86% (n = 8), endophthalmitis in 0.72% (n = 2), raised intraocular pressure in 12.54% (n = 35), diplopia in 0.72% (n = 2), retinal detachment in 5.73% (n = 16), and dislocation of the SSFIOL in 4.6% (n = 13). The mean follow-up after SSFIOL implantation was 39.68 months. Conclusions: SSFIOLs are effective in correcting aphakia in children; long-term follow-up of these children is, however, necessary.