Pediatric bag-in-the-lens intraocular lens implantation: long-term follow-up

Jan Van Looveren; Sorcha Ní Dhubhghaill; Daisy Godts; Ellen Bakker; Ilse De Veuster; Danny G P Mathysen; Marie-José Tassignon

doi:10.1016/j.jcrs.2014.12.057

Pediatric bag-in-the-lens intraocular lens implantation: long-term follow-up

J Cataract Refract Surg. 2015 Aug;41(8):1685-92. doi: 10.1016/j.jcrs.2014.12.057.

Authors

Jan Van Looveren¹, Sorcha Ní Dhubhghaill², Daisy Godts², Ellen Bakker², Ilse De Veuster², Danny G P Mathysen², Marie-José Tassignon²

Affiliations

¹ 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.
² 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.

PMID: 26432126
DOI: 10.1016/j.jcrs.2014.12.057

Abstract

Purpose: To evaluate long-term follow-up results of pediatric cataract surgery using the bag-in-the-lens (BIL) intraocular lens (IOL) implantation technique.

Setting: Antwerp University Hospital, Edegem, Antwerp, Belgium.

Design: 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.

Conclusion: 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.

Financial disclosure: 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.

MeSH terms

Adolescent
Cataract / congenital
Cataract / physiopathology
Child
Child, Preschool
Female
Follow-Up Studies
Humans
Infant
Intraoperative Complications
Lens Capsule, Crystalline / surgery*
Lens Implantation, Intraocular / methods*
Lenses, Intraocular*
Male
Phacoemulsification
Postoperative Complications
Prospective Studies
Pseudophakia / physiopathology*
Refraction, Ocular / physiology
Visual Acuity / physiology