Journal d'ophtalmologie clinique et expérimentale
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Abstrait

Evaluation of secondary implantation of posterior chamber intraocular lens following pars-plicata lensectomy versus limbal irrigation aspiration in aphakic children

Hatem A Saeed

Aim of work: To evaluate the intra-operative technical advantages and difficulties of secondary implantation of posterior chamber intraocular lens following pars-plicata lensectomy versus limbal irrigation aspiration as well as postoperative results in aphakic children.

Subjects and Methods: Twenty eyes of 17 children were enrolled in this study .The age at the initial cataract surgery ranged from 4 months to 3 years. The age at the second surgery ranged from 4 -8 years (mean of 6 ±1.414). Twenty aphakic eyes divided into 2 groups: Group 1 included 10 eyes who underwent secondary implantation of PCIOL in the ciliary sulcus following pars-plicata lensectomy. Group 2 included 10 eyes who underwent secondary implantation of PCIOL in the ciliary sulcus following limbal irrigation aspiration. During preoperative ophthalmic examination; particular attention was given to the presence of: posterior synechiae to the posterior capsular rim, pupillary irregularity, extent of pupillary dilatation and the presence of any trapped cortical matter inside the capsular adhesions. Intra-operatively ; certain parameters were evaluated including :the need to dissect posterior synechiae to the posterior capsular rim threatening the enlargement of posterior capsular opening with vitreous prolapse, the need to dissect capsular adhesions to remove trapped cortical matter, the need to perform sulcus dissection and reformation, the ease of lens implantation and the final lens centration .Postoperatively; the degree of postoperative reaction, centration of the implant and the pupil regularity were reported. 

Results: Previous pars-plicata lensectomy offered several intra-operative technical advantages to secondary implantation compared to previous limbal irrigation aspiration regarding: Less posterior synechiae, less pupillary irregularity, better pupillary dilatation, absence of the need to perform capsular or sulcus dissection, less need to perform cortical clean up, easier IOL implantation and better final lens centration .Postoperatively; less reaction, better lens centration and less pupillary irregularity were reported in group 1.

Conclusion: Secondary implantation of PCIOL following pars-plicata lensectomy was easier with more intra-operative technical advantages and less difficulties and with better postoperative results compared to secondary implantation of PCIOL following limbal irrigation aspiration in aphakic children.