Pars plana vitrectomy with endoscope-guided sutured posterior chamber intraocular lens implantation in children and adults

Timothy Olsen, Jonathan T. Pribila

Research output: Contribution to journalArticle

34 Citations (Scopus)

Abstract

Purpose To describe a novel method for placement of a sulcus-fixated, sutured posterior chamber intraocular lens (sf-SPC-IOL) using endoscopic guidance during pars plana vitrectomy surgery. Design A retrospective case-series by a single surgeon in both pediatric and adult patients undergoing sf-SPC-IOL in the setting of posterior segment surgery. Methods Seventy-four eyes of 71 patients had pars plana vitrectomy and placement of an sf-SPC-IOL in an academic, outpatient setting. Preoperative diagnosis included trauma (42%), subluxated lenses with no capsular support (24%), uveitis (15%), congenital cataract (11%), Marfan syndrome or ectopia lentis (6%), and other (2%). Fifty-one adults and 20 children (<18 years of age) were reviewed from cases performed from 1999 through 2007. The sf-SPC-IOL sutures were placed using endoscopic visualization of ab interno scleral fixation. Results The mean follow-up time was nearly 3 years (3 months to 9 years) and most patients experienced an improvement in visual function. Many eyes had advanced posterior segment disorders. Only 2 broken sutures occurred, both attributable to repeat trauma. Advantages of this technique include: excellent visualization and haptic localization, optimal lens centration, buried knots, broad scleral imbrication, and minimal vitreous- and hemorrhage-related complications. Disadvantages include the learning curve, increased operative time, long-term suture stability issues, and limited availability of intraocular endoscopes. Conclusions Endoscopic-guided sf-SPC-IOL using this approach, in the setting of posterior segment disease, is a reasonable option for visual rehabilitation in both pediatric and adult patients.

Original languageEnglish (US)
Pages (from-to)287-296.e2
JournalAmerican journal of ophthalmology
Volume151
Issue number2
DOIs
StatePublished - Jan 1 2011
Externally publishedYes

Fingerprint

Intraocular Lens Implantation
Temazepam
Endoscopes
Intraocular Lenses
Vitrectomy
Sutures
Lenses
Ectopia Lentis
Pediatrics
Vitreous Hemorrhage
Marfan Syndrome
Learning Curve
Uveitis
Wounds and Injuries
Operative Time
Cataract
Outpatients
Rehabilitation

ASJC Scopus subject areas

  • Ophthalmology

Cite this

Pars plana vitrectomy with endoscope-guided sutured posterior chamber intraocular lens implantation in children and adults. / Olsen, Timothy; Pribila, Jonathan T.

In: American journal of ophthalmology, Vol. 151, No. 2, 01.01.2011, p. 287-296.e2.

Research output: Contribution to journalArticle

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