Safety of transscleral-sutured intraocular lenses in children

J AAPOS. 2008 Oct;12(5):431-9. doi: 10.1016/j.jaapos.2008.04.016. Epub 2008 Aug 15.


Purpose: 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.

MeSH terms

  • Adolescent
  • Child
  • Child, Preschool
  • Equipment Design
  • Equipment Failure
  • Follow-Up Studies
  • Foreign-Body Migration / etiology
  • Humans
  • Infant
  • Intraoperative Complications
  • Lens Implantation, Intraocular / adverse effects
  • Lens Implantation, Intraocular / methods*
  • Polypropylenes / adverse effects
  • Postoperative Complications
  • Retrospective Studies
  • Sclera / surgery*
  • Suture Techniques / adverse effects*
  • Sutures / adverse effects*
  • Visual Acuity


  • Polypropylenes