title: Pediatric bag-in-the-lens intraocular lens implantation: long-term follow-up.
abstract: OBJECTIVE
  To evaluate long-term follow-up results of pediatric cataract surgery using the bag-in-the-lens (BIL) intraocular lens (IOL) implantation technique.
  
  
  METHODS
  Antwerp University Hospital, Edegem, Antwerp, Belgium.
  
  
  METHODS
  Prospective case series.
  
  
  METHODS
  All pediatric cataract surgeries with BIL IOL implantation performed at the Antwerp University Hospital were evaluated. Only cases that completed a follow-up of 5 years at the hospital's Department of Ophthalmology were included in this study.
  
  
  RESULTS
  Forty-six eyes of 31 children had a complete follow-up of 5 years or more after BIL IOL implantation. Sixteen cases were unilateral and 15 were bilateral. Patient age at time of surgery ranged from 2 months to 14 years. The mean refraction at the end of follow-up was -1.99 diopters (D) ± 3.70 (SD). In bilateral cases, a corrected distance visual acuity (CDVA) of better than 0.5 was attained in 86.7% and a CDVA of 1.0 was achieved in 56.7%. In unilateral cases, 31.2% achieved a CDVA of better than 0.5 but none obtained a CDVA of 1.0. A clear visual axis was maintained in 91.3% of cases during follow-up. Visual axis reopacification was detected in 4 eyes of 3 cases, all due to inadequate BIL IOL positioning. None of these eyes needed more than 1 intervention to maintain visual axis clarity. Other than 1 case of glaucoma, no severe complications were detected.
  
  
  CONCLUSIONS
  Long-term follow-up results show that BIL IOL implantation is a safe, well-tolerated approach for treating pediatric cataract with a very low rate of visual axis reopacification and a low rate of secondary interventions for other postoperative complications.
  
  
  BACKGROUND
  Dr. Tassignon has intellectual property rights to the bag-in-the-lens intraocular lens (U.S. patent 6 027 531; EU patent 009406794.PCT/120268), which is licensed to Morcher GmbH, Stuttgart, Germany. No other author has a financial or proprietary interest in any material or method mentioned.
authors.affiliation: From the Department of Ophthalmology (Van Looveren, Ní Dhubhghaill, Godts, Bakker, De Veuster, Mathysen, Tassignon), Antwerp University Hospital, Edegem, and the Faculty of Medicine and Health Sciences (Van Looveren, De Veuster, Mathysen, Tassignon), University of Antwerp, Antwerp, Belgium. Electronic address: jan.van.looveren@uza.be.
authors.forename: Jan
authors.initials: J
authors.lastname: Van Looveren
authors.affiliation: From the Department of Ophthalmology (Van Looveren, Ní Dhubhghaill, Godts, Bakker, De Veuster, Mathysen, Tassignon), Antwerp University Hospital, Edegem, and the Faculty of Medicine and Health Sciences (Van Looveren, De Veuster, Mathysen, Tassignon), University of Antwerp, Antwerp, Belgium.
authors.forename: Sorcha
authors.initials: S
authors.lastname: Ní Dhubhghaill
authors.affiliation: From the Department of Ophthalmology (Van Looveren, Ní Dhubhghaill, Godts, Bakker, De Veuster, Mathysen, Tassignon), Antwerp University Hospital, Edegem, and the Faculty of Medicine and Health Sciences (Van Looveren, De Veuster, Mathysen, Tassignon), University of Antwerp, Antwerp, Belgium.
authors.forename: Daisy
authors.initials: D
authors.lastname: Godts
authors.affiliation: From the Department of Ophthalmology (Van Looveren, Ní Dhubhghaill, Godts, Bakker, De Veuster, Mathysen, Tassignon), Antwerp University Hospital, Edegem, and the Faculty of Medicine and Health Sciences (Van Looveren, De Veuster, Mathysen, Tassignon), University of Antwerp, Antwerp, Belgium.
authors.forename: Ellen
authors.initials: E
authors.lastname: Bakker
authors.affiliation: From the Department of Ophthalmology (Van Looveren, Ní Dhubhghaill, Godts, Bakker, De Veuster, Mathysen, Tassignon), Antwerp University Hospital, Edegem, and the Faculty of Medicine and Health Sciences (Van Looveren, De Veuster, Mathysen, Tassignon), University of Antwerp, Antwerp, Belgium.
authors.forename: Ilse
authors.initials: I
authors.lastname: De Veuster
authors.affiliation: From the Department of Ophthalmology (Van Looveren, Ní Dhubhghaill, Godts, Bakker, De Veuster, Mathysen, Tassignon), Antwerp University Hospital, Edegem, and the Faculty of Medicine and Health Sciences (Van Looveren, De Veuster, Mathysen, Tassignon), University of Antwerp, Antwerp, Belgium.
authors.forename: Danny G P
authors.initials: DG
authors.lastname: Mathysen
authors.affiliation: From the Department of Ophthalmology (Van Looveren, Ní Dhubhghaill, Godts, Bakker, De Veuster, Mathysen, Tassignon), Antwerp University Hospital, Edegem, and the Faculty of Medicine and Health Sciences (Van Looveren, De Veuster, Mathysen, Tassignon), University of Antwerp, Antwerp, Belgium.
authors.forename: Marie-José
authors.initials: MJ
authors.lastname: Tassignon
mesh_terms: D000293:Adolescent; D002386:Cataract / Q000151:congenital / Q000503:physiopathology; D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D007431:Intraoperative Complications; D007903:Lens Capsule, Crystalline / Q000601:surgery*; D019654:Lens Implantation, Intraocular / Q000379:methods*; D007910:Lenses, Intraocular; D008297:Male; D018918:Phacoemulsification; D011183:Postoperative Complications; D011446:Prospective Studies; D019591:Pseudophakia / Q000503:physiopathology*; D012029:Refraction, Ocular / Q000502:physiology; D014792:Visual Acuity / Q000502:physiology