Safety of transscleral-sutured intraocular lenses in children.
OBJECTIVE
To evaluate the long-term efficacy, safety, and advisability of transscleral-sutured posterior chamber intraocular lenses (IOLs) in pediatric patients with no capsular support and to determine whether a 10-0 polypropylene suture should be used for this purpose.


METHODS
A long-term retrospective interventional case series review of 33 eyes of 26 patients who had a sutured IOL at Duke University Eye Center. Cases were evaluated for the intraoperative surgical risks and the number, type, and severity of the postoperative complications. A survey of pediatric ophthalmologists' experience with suture breakage was performed.


RESULTS
Intraoperative and immediate postoperative complications were minimal and not sight-threatening for the patient. Four patients developed subluxation of the IOL secondary to spontaneous 10-0 polypropylene suture breakage at 3.5, 5, 6, and 8 years after surgery. A survey of pediatric ophthalmologists revealed 13 similar cases (mean, 5 years after surgery).


CONCLUSIONS
Caution should be exercised in the use of 10-0 polypropylene suture to fixate an IOL to the sclera in children, and an alternative material or size (such as 9-0 polypropylene) should be considered.
Buckley
Edward G
EG
Duke Eye Center, Durham, North Carolina 27710, USA. buckl002@mc.duke.edu
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D004867:Equipment Design; D004868:Equipment Failure; D005500:Follow-Up Studies; D005548:Foreign-Body Migration / Q000209:etiology; D006801:Humans; D007223:Infant; D007431:Intraoperative Complications; D019654:Lens Implantation, Intraocular / Q000009:adverse effects / Q000379:methods*; D011126:Polypropylenes / Q000009:adverse effects; D011183:Postoperative Complications; D012189:Retrospective Studies; D012590:Sclera / Q000601:surgery*; D013536:Suture Techniques / Q000009:adverse effects*; D013537:Sutures / Q000009:adverse effects*; D014792:Visual Acuity
D011126:Polypropylenes