Clinical Results of Secondary Intraocular Lens Implantation in Bilateral Congenital Cataract

PURPOSE: To evaluate the long-term visual outcomes of secondary posterior chamber intraocular lens implantation after 2 years of age for bilateral congenital cataract. METHODS: A retrospective case review was conducted of 42 pediatric patients who were diagnosed with bilateral congenital cataract and underwent irrigation and aspiration of lenses, posterior capsulectomy, anterior vitrectomy, and after two years of age secondary posterior chamber intraocular lens implantation. RESULTS: The median age at irrigation and aspiration of the lens was 21 weeks; the median age at secondary intraocular lens implantation was 5.5 years; the median age at the last follow-up was 11.1 years. The final visual acuities were 0.42 in the better eye and 0.23 in the fellow eye. The median refractive error at the final follow-up was -2.5 diopters of spherical equivalent, and 1.2 diopters in the amount of astigmatism. For all cases, no posterior capsule opacification, intraocular lens dislocation, or retinal detachment was found. There were 16 postoperative glaucoma patients (19.0%), and their intraocular pressures were well controlled with medical therapy. CONCLUSIONS: Secondary posterior chamber intraocular lens implantation performed after two years of age can be an effective therapy for visual development in patients with bilateral congenital cataract undergoing irrigation and aspiration of the lens, posterior capsulectomy, anterior vitrectomy, and aphakic spectacle correction.

Evaluation of the postoperative spherical refractive error in trans pars plana vitreo-lensectomy in combination with intraocular lens insertion among patients with ocular injury

Background: The postoperative residual spherical equivalent (SE) refractive error of the posterior chamber intraocular lens insertion is the cause result in significant distant vision loss. Objective: The study evaluated residual SE refractive error of the patients having ocular trauma undergoing a trans pars plana vitreo-lensectomy and posterior chamber intraocular lens insertion, for recorrection of the preoperative IOL power calculated formula are also investigated. Subjects: 43 consecutive patients who underwent a trans pars plana vitreo-lensectomy and posterior chamber intraocular lens insertion in the sulcus, in the Trauma Department of National Institute of Ophthalmology, from December 2005 to June 2007. Method: This was a prospective cross-sectional study. Results: Among 43 patients, there were 39 men and 4 women, age ranged from 10 to 45 years. In the most cases, the residual spherical equivalent deviation was planned to achieve final mild myopia (mean -1.75 D by manifest refraction; -1.9 D by autorefractor measurements). The surgery could provide a best corrected visual acuity at over 0.2 (81.4%). Conclusions: Intraocular lens implantation at the time of trans pars plana vitreo-lensectomy could provide a reasonable restoration of visual acuity and binocular function. However, recorrection of the IOL power calculation was necessary in these cases.

Clinical Results of Primary Posterior Chamber Intraocular Lens Insertion in the Setting of Penetrating Ocular Trauma: whether PCL insertion or not

PURPOSE: To evaluate the clinical outcome of patients who underwent a lensectomy and IOL implantation at the time of the primary repair due to a penetrating ocular injury. METHODS: We analyzed the records of 25 eyes of 25 perforating injury patients[Group A (13 eyes)-who had undergone simultaneous corneal laceration repair, cataract extraction and IOL implantation, and Group B (12 eyes)-who had undergone corneal laceration repair, cataract extraction and had their refractive error corrected by contact lens or glasses later]. retrospectively from March, 1991 to June,1999. We examined the relationship between their final visual acuity and the influencing factors such as cause of injury, length and feature of the lacerated cornea, initial visual acuity and postoperative complications, etc. RESULTS: The average age of patients was 36.8 and 25.7 years in group A and B, respectively. The major cause of injury was a metallic foreign body. In group A, the wound is relatively short and has a linear shape. In group B, it is a nearly curved line. An anterior vitrectomy was done in 6 patients in both groups, respectively. Nine patients (69%) achieved a final visual acuity of 10/20 or better in group A and only four patients (33%) in group B. The postoperative complications were transient elevation of IOP (1 eye) and corneal ulcer (1 eye) in group A, and vitreous opacity (1 eye) and retinal detachment (1 eye) in group B. CONCLUSIONS: It is recommended for visual rehabilitation and attainment of binocular visual function to implant the IOL at the time of primary repair caused by a penetrating ocular injury.