Refractive exchange of supplementary intraocular lens (RESI) for pediatric cataract

Session Details

Session Title: Cataract Surgery Special Cases

Session Date/Time: Sunday 06/09/2015 | 10:30-12:30

Paper Time: 11:48

Venue: Room 10

First Author: : G.Kahraman AUSTRIA

Co Author(s): :    M. Amon   F. Prager                 

Abstract Details

Purpose:

Refractive results in pediatric cataract surgery with IOL are highly variable. It is also difficult to achieve a precise and stable correction with in time, because in children the eye is in anatomic and refractive development. In this study we evaluated the refractive change in pediatric poly-pseudophakia.

Setting:

Department of Ophthalmology, Academic Teaching Hospital of St John of God, Vienna, Austria
.

Methods:

The (Sulcoflex®) IOL is designed for implantation into the ciliary sulcus in pseudophakic eyes (“piggy back”). It is a single-piece implant made of hydrophilic acrylic. Optic- and haptic edges are round. The optic has a diameter of 6.5 mm and a concave/convex shape for perfect fit on the anterior convex surface of the primary IOL. The haptic is angulated, and has an undulated design to preclude IOL rotation. Sulcoflex® implantation has been done through a clear corneal incision (2.75 mm) under general anesthesia using a standardized technique. After surgery slit lamp examination and visual function were assessed.

Results:

In this prospective study 5 eyes of 5 patients received a monofocal Sulcoflex® IOL with a primary IOL in the capsular bag. All surgeries were uneventful. Postoperative emmetropia (± 0.25 D) was achieved in all cases. In 2 cases fibrin was seen in the pupillary area during the first days after surgery. Occlusion therapy was possible in all patients. At the last visit all eyes were without inflammation and the two IOLs were well accepted. After 2 years of surgery, the first case developed myopia (-3 diopters). Refractive Exchange of Supplementary Intraocular lens (RESI) was performed to achieve emmetropia. The surgery went uneventful.

Conclusions:

The Sulcoflex® IOL is well tolerated within the pediatric eye. The implant can be used at the same time with the primary implant or at a later time as secondary implant. If the refraction change is more than as expected, a Supplementary IOL exchange can be performed.

Financial Interest:

One of the authors gains financially from product or procedure presented