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Long-term outcomes of secondary intraocular lens implantation in children

  • Pediatrics
  • Published:
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Abstract

Purpose

This study aims to report long-term outcomes of secondary intraocular lens (IOL) implantation after early cataract surgery in children.

Methods

This is a retrospective case series that included children undergoing secondary IOL implantation. The patients had either in-the-bag (ITB) or sulcus implantation; alternative methods of IOL fixation were excluded. Single-piece acrylic IOL was used for ITB and 3-piece acrylic or PMMA IOL for sulcus implantation. The visual acuity outcomes and rate of complications at the last follow-up visit were evaluated.

Results

One hundred six eyes (70 patients) were analyzed. The mean follow-up was 5.5 ± 3.8 years. Sixty-two eyes (58.5%) had ITB; 44 eyes (41.5%) had sulcus IOL. All but 3 eyes (97.2%) showed stable or improvement in visual acuity. Early inflammation > grade 2 + was noted with sulcus IOL (84% vs 34%, p = 0.01); late inflammation requiring vitrectomy occurred in one eye with sulcus IOL. Mild decentration was seen in 2 eyes with sulcus IOL; one additional subluxed sulcus IOL was exchanged. Sixteen out of 106 eyes (16%) had glaucoma. Eyes that developed glaucoma had early primary surgery (mean, 0.2 years, p < 0.001, significant); there was no difference in glaucoma rates based on implantation site.

Conclusion

Early postoperative inflammation is higher in eyes with sulcus implantation, but good visual acuity outcomes are noted after secondary IOL implantation in children. Glaucoma is the main complication that requires close monitoring and is associated with early age at primary surgery.

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References

  1. Nihalani BR, VanderVeen DK (2011) Secondary intraocular lens implantation after pediatric aphakia. J AAPOS 15:435–440

    Article  PubMed  Google Scholar 

  2. Wilson ME Jr, Englert JA, Greenwald MJ (1998) In-the-bag secondary intraocular lens implantation in children. J AAPOS 3:350–355

    Article  Google Scholar 

  3. Grewal DS, Basti S (2012) Modified technique for removal of Soemmerring ring and in-the-bag secondary intraocular lens placement in aphakic eyes. J Cataract Refract Surg 38:739–742

    Article  PubMed  Google Scholar 

  4. Bothun ED, Wilson ME, VanderVeen DK, Plager DA, Freedman SF, Trivedi RH, Traboulsi EI, Anderson JS, Loh AR, Yen KG, Weil NC, Morrison D, Lambert SR (2020) Outcomes of bilateral cataracts removed in infants 1 to 7 months of age using the Toddler Aphakia and Pseudophakia Treatment Study Registry. Ophthalmology 127:501–510

    Article  PubMed  Google Scholar 

  5. Bothun ED, Wilson ME, Traboulsi EI, Diehl NN, Plager DA, VanderVeen DK, Freedman SF, Yen KG, Weil NC, Loh AR, Morrison D, Anderson JS, Lambert SR (2019) Outcomes of unilateral cataracts in infants and toddlers 7 to 24 months of age: Toddler Aphakia and Pseudophakia Study (TAPS). Ophthalmology 126:1189–1195

    Article  PubMed  Google Scholar 

  6. Writing committee for the Pediatric Eye Disease Investigator Group (PEDIG), Repka MX, Dean TW, Kraker RT, Bothun ED, Morrison DG, Lambert SR, Stahl ED, Wallace DK (2019) Visual acuity and ophthalmic outcomes in the year after cataract surgery among children younger than 13 years. JAMA Ophthalmol 137:817–824

    Article  Google Scholar 

  7. Nihalani BR, VanderVeen DK (2017) Benchmarks for outcome indicators in pediatric cataract surgery. Eye (Lond) 31:417–421

    Article  CAS  Google Scholar 

  8. Lambert SR, Cotsonis G, DuBois L, AzharNizam MS, Kruger SJ, Hartmann EE, Weakley DR Jr, Drews-Botsch C, Infant aphakia treatment group (2020) Long-term effect of intraocular lens vs contact lens correction on visual acuity after cataract surgery during infancy: a randomized clinical trial. JAMA Ophthalmol 138:365–72

    Article  PubMed  PubMed Central  Google Scholar 

  9. Shenoy BH, Mittal V, Gupta A, Sachdeva V, Kekunnaya R (2015) Complications and visual outcomes after secondary intraocular lens implantation in children. Am J Ophthalmol 159:720–726

    Article  PubMed  Google Scholar 

  10. Crnic T, Weakley DR Jr, Stager D Jr, Felius J (2004) Use of Acrysof acrylic foldable intraocular lens for secondary implantation in children. J AAPOS 8:151–155

    Article  PubMed  Google Scholar 

  11. Trivedi RH, Wilson ME Jr, Facciani J (2005) Secondary intraocular lens implantation for pediatric aphakia. J AAPOS 9:346–352

    Article  PubMed  Google Scholar 

  12. Wood KS, Tadros D, Trivedi RH, Wilson ME (2016) Secondary intraocular lens implantation following infantile cataract surgery: intraoperative indications, postoperative outcomes. Eye 30:1182–1186

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  13. Chen TC, Bhatia LS, Walton DS (2005) Complications of pediatric lensectomy in 193 eyes. Ophthalmic Surg Lasers Imaging 36:6–13

    Article  PubMed  Google Scholar 

  14. Lambert SR, Purohit A, Superak HM, Lynn MJ, Beck AD (2013) Long term risk of glaucoma after congenital cataract surgery. Am J Ophthalmol 156:355–61

    Article  PubMed  Google Scholar 

  15. Freedman SF, Lynn MJ, Beck AD, Bothun ED, Orge FH, Lambert SR, Infant Aphakia Treatment Study Group (2015) Glaucoma-related adverse events in the first five years after unilateral cataract removal in the Infant Aphakia Treatment Study. JAMA Ophthalmol 133:907–914

    Article  PubMed  PubMed Central  Google Scholar 

  16. VanderVeen DK, Drews-Botsch CD, Nizam A, Bothun ED, Wilson LB, Wilson ME, Lambert SR (2021) Outcomes of secondary intraocular lens implantation in the infant aphasia treatment study. J Cataract Refract Surg 47:172–177

    Article  PubMed  PubMed Central  Google Scholar 

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Funding

The research was supported by Boston Children’s Hospital Ophthalmology Foundation Endowment Fund. Dr. VanderVeen has received consulting fees and participated in research with Ophtec, Inc.

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Authors and Affiliations

  1. Boston Children’s Hospital, Harvard Medical School, 300 Longwood Avenue, Boston, MA, 02115, USA

    Bharti R. Nihalani & Deborah K. VanderVeen

Authors
  1. Bharti R. Nihalani
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  2. Deborah K. VanderVeen
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Corresponding author

Correspondence to Bharti R. Nihalani.

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Ethics approval

All procedures performed in this study involving human participants were in accordance with the ethical standards of Boston Children’s Hospital and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

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Informed consent was not required for this study as this was a retrospective chart review.

Conflict of interest

The authors declare no competing interests.

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Nihalani, B.R., VanderVeen, D.K. Long-term outcomes of secondary intraocular lens implantation in children. Graefes Arch Clin Exp Ophthalmol 260, 1733–1739 (2022). https://doi.org/10.1007/s00417-021-05467-8

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  • DOI: https://doi.org/10.1007/s00417-021-05467-8

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