EPOS

European Paediatric Ophthalmological Society

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22 Intraocular correction with foldable IOL in pediatric traumatic cataracts

Bobrova, N.F., Enukidze, D.Z.
The Filatov Institute of Eye Diseases and Tissue Therapy, Odessa, Ukraine

The analysis of a significant number of children (710) with trauma of anterior the part of an eye has shown, that the lens damage in 90,2% of cases is combined with damages of other structures: corneal scars - ( 76,4%), iris injury (- 66,0%). The transition to implantation of posterior chamber IOL has allowed to reduce the volume of surgical interventions. Nevertheless, the various kinds of specific complications of traumatic cataract implantation surgery as IOL dislocation and decentration, "capture of a pupil" are marked in 5,1 - 14% of supervision.

Purpose: of this work was the definition of influence of surgical implantation of flexible IOL on frequency and character of complications in pediatric cataracts.

Results: of surgical intervention in 32 children (32 eyes) with traumatic cataract after penetrating (22 eyes) and blunt injuries (10 eyes), complicated by corneal scars in 75,0% and various iris pathology in 65,6% were analysed. Cataracts were removed by phacoemulsification method with sclerocorneal tunnel incisions (2,7-3,0mm). soft flexible IOLs "Acrysof" of Alcon - were implantated with the use of viscoelastic. Implantation in the capsular bag was carried out in 20 cases, in the sulcus - in 12. In 5 children a traumatic defect of the posterior capsule was predetermining the necessity of partial anterior vitrectomy. Simultaneous anterior and posterior synechiotomy was carried out in 41,8% cases, in 18,7% - iridoplastic. Exudative reaction of I - II degree was noticed in 6 eyes, 5 of which with fresh intumescent cataracts. Visual acuity increased in all patients: up to 0,3 - 1,0 in 78,1%, up to 0,1- 0,2 in 21,9%. In the longer follow-up (2-19 months) complications were diagnosed in 43,3%. Secondary cataract was the most frequent with 50,0%, the relapse of posterior synechias was noticed in 35,7% eyes, in 14,2% has taken place IOL decentration, still in 14,2 % "capture of a pupil".

The achieved results testify considerably less exudative reaction of the eyes to the surgical trauma, that may be explained, by a decrease of the traumatic intervention due to reduction of the incision with the use of viscoelastic and IOLs of more biocompatible materials.