Optic-Reconstructive Surgery in Children With Implantation of the Iridium-Lens Complex Artificial Iris + IOL
Purpose
To evaluate the effectiveness of the implantation of irido-lens complex "Artificial iris-IOL" ("MIOL-Iris") in children with congenital cataract and aniridia.
Methods
9 children (18 eyes) aged 5 to 14 years with congenital cataract and aniridia were operated. The microphakia was noted in majority of patients, in 2 cases - a dystopia of the lens. Visual functions were on average 0, 05±0, 01. The lens was removed by phacoaspiration, the discision hole was formed in the posterior capsule by posterior capsulorhexis. Polymer disk-shaped optical-haptic monolithic irido-intraocular IOL "MIOL-Iris" (production of "Rapper-NN" Russia) was implanted on a capsular support and fixed in the ciliary sulcus or, if necessary, was sutured to the sclera. Follow-up period after surgery was up to 5 years.
Results
Visual acuity after surgery improved to 0, 1±0, 02 (p<0.001). The decrease of photophobia and satisfactory cosmetic effect were noted in all children. In the first 3 months after surgery an increase of intraocular pressure (IOP) to 27-32 mm Hg was noted in 66.7% of cases, which was compensated by medication. Antiglaucomatous surgical procedures were performed in 4 children (5 eyes). In 3 cases the retrolental fibrous membrane was formed in 5-8 months that was removed by laser discision. In both eyes of 3 patients the prelimbic keratopathy developed in 1 and 2 years.
Conclusion
Implantation of complex "Artificial Iris + IOL" in children can improve visual functions, eliminate the effect of light dispersion and achieve a good cosmetic result. However, complications developing in the long term require additional correction of treatment.