title: Long-Term Outcomes of Iris-sutured Posterior Chamber Intraocular Lenses in Children.
abstract: OBJECTIVE
  To report the long-term outcomes and complications of iris-sutured posterior chamber intraocular lenses (PCIOLs) in the pediatric population.
  
  
  METHODS
  Retrospective interventional case study.
  
  
  METHODS
  This study involved 12 consecutive pediatric patients (17 eyes) who underwent placement of foldable iris-sutured PCIOLs between September 2004 and September 2007. Outcome measures included change in visual acuity and complications.
  
  
  RESULTS
  Of the 17 eyes were reviewed, 6 (35%) had hereditary or idiopathic ectopia lentis, 5 (29%) had Marfan syndrome, 2 (12%) were aphakic after pars plana vitrectomy and 4 (24%) were aphakic after surgical intervention for trauma. Average follow-up was 4.69 ± 3.21 years and mean age of surgery was 7.21 ± 3.78 years. Seven eyes suffered dislocation of the PCIOL an average of 12.11 ± 11.97 months after surgery, with 2 patients undergoing dislocation a second time. There was a higher rate of dislocation in patients with a history of ectopia lentis due to Marfan syndrome, idiopathic causes, or hereditary causes than in patients being treated for aphakia resulting from other causes (71% vs 29%). Mean visual acuity improved in 12 of 17 patients (71%), from 0.80 ± 0.6 logMAR preoperatively to 0.35 ± 0.5 logMAR at most recent visit, P = .009. One eye of a Marfan patient sustained a retinal detachment 8 months after dislocation of the PCIOL, and 1 patient experienced iris capture of the PCIOL after surgery.
  
  
  CONCLUSIONS
  Iris-sutured intraocular lenses have been used as an alternative to transsclerally sutured intraocular lenses to correct aphakia in pediatric patients. Dislocation of the intraocular lenses can occur frequently, however. The procedure should be considered with caution in pediatric patients.
authors.affiliation: Department of Ophthalmology, Baylor College of Medicine, Houston, Texas.
authors.forename: Ravi
authors.initials: R
authors.lastname: Shah
authors.affiliation: Department of Ophthalmology, Baylor College of Medicine, Houston, Texas.
authors.forename: Mitchell P
authors.initials: MP
authors.lastname: Weikert
authors.affiliation: Department of Ophthalmology and Pediatrics, Texas Children's Hospital and Baylor College of Medicine, Houston, Texas.
authors.forename: Charity
authors.initials: C
authors.lastname: Grannis
authors.affiliation: Department of Ophthalmology, Baylor College of Medicine, Houston, Texas.
authors.forename: Marshall B
authors.initials: MB
authors.lastname: Hamill
authors.affiliation: Department of Ophthalmology and Pediatrics, Texas Children's Hospital and Baylor College of Medicine, Houston, Texas.
authors.forename: Lingkun
authors.initials: L
authors.lastname: Kong
authors.affiliation: Department of Ophthalmology and Pediatrics, Texas Children's Hospital and Baylor College of Medicine, Houston, Texas. Electronic address: kgyen@texaschildrens.org.
authors.forename: Kimberly G
authors.initials: KG
authors.lastname: Yen
mesh_terms: D000293:Adolescent; D001036:Aphakia, Postcataract / Q000601:surgery; D060437:Artificial Lens Implant Migration / Q000209:etiology; D002386:Cataract / Q000150:complications; D002648:Child; D002675:Child, Preschool; D004479:Ectopia Lentis / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D007431:Intraoperative Complications; D007498:Iris / Q000601:surgery*; D019654:Lens Implantation, Intraocular / Q000379:methods*; D008297:Male; D011183:Postoperative Complications; D012189:Retrospective Studies; D013536:Suture Techniques; D016896:Treatment Outcome; D014792:Visual Acuity / Q000502:physiology