title: Pars plana vitrectomy with endoscope-guided sutured posterior chamber intraocular lens implantation in children and adults.
abstract: OBJECTIVE
  To describe a novel method for placement of a sulcus-fixated, sutured posterior chamber intraocular lens (sf-SPC-IOL) using endoscopic guidance during pars plana vitrectomy surgery.
  
  
  METHODS
  A retrospective case-series by a single surgeon in both pediatric and adult patients undergoing sf-SPC-IOL in the setting of posterior segment surgery.
  
  
  METHODS
  Seventy-four eyes of 71 patients had pars plana vitrectomy and placement of an sf-SPC-IOL in an academic, outpatient setting. Preoperative diagnosis included trauma (42%), subluxated lenses with no capsular support (24%), uveitis (15%), congenital cataract (11%), Marfan syndrome or ectopia lentis (6%), and other (2%). Fifty-one adults and 20 children (<18 years of age) were reviewed from cases performed from 1999 through 2007. The sf-SPC-IOL sutures were placed using endoscopic visualization of ab interno scleral fixation.
  
  
  RESULTS
  The mean follow-up time was nearly 3 years (3 months to 9 years) and most patients experienced an improvement in visual function. Many eyes had advanced posterior segment disorders. Only 2 broken sutures occurred, both attributable to repeat trauma. Advantages of this technique include: excellent visualization and haptic localization, optimal lens centration, buried knots, broad scleral imbrication, and minimal vitreous- and hemorrhage-related complications. Disadvantages include the learning curve, increased operative time, long-term suture stability issues, and limited availability of intraocular endoscopes.
  
  
  CONCLUSIONS
  Endoscopic-guided sf-SPC-IOL using this approach, in the setting of posterior segment disease, is a reasonable option for visual rehabilitation in both pediatric and adult patients.
authors.affiliation: Emory Eye Center, Emory University Department of Ophthalmology, Atlanta, Georgia 30322, USA.
authors.forename: Timothy W
authors.initials: TW
authors.lastname: Olsen
authors.forename: Jonathan T
authors.initials: JT
authors.lastname: Pribila
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001036:Aphakia, Postcataract / Q000601:surgery; D002648:Child; D002675:Child, Preschool; D004724:Endoscopy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D019654:Lens Implantation, Intraocular / Q000379:methods*; D008297:Male; D008875:Middle Aged; D057972:Posterior Eye Segment / Q000601:surgery*; D012189:Retrospective Studies; D012599:Sclerostomy; D013536:Suture Techniques; D014786:Vision Disorders / Q000534:rehabilitation; D014792:Visual Acuity / Q000502:physiology; D014821:Vitrectomy; D055815:Young Adult