Zastosowanie sztucznych akrylowych soczewek wewnątrzgałkowych w chirurgii zaćmy u dzieci - doświadczenia własne
The Use of the Artificial Acrylic Intraocular Lenses in Childrens' Cataract Surgery - the Own Experiences
Krystyna Kanigowska, Mirosława Grałek
Klinika Okulistyki Instytutu "Pomnik - Centrum Zdrowia Dziecka" w Warszawie Kierownik: prof. dr hab. n. med. Mirosława Grałek
Summary: Purpose: To evaluate the outcome and safety of foldable 1-piece acrylic hydrophobic IOL implantation in children. Material and Methods: The results of cataract extraction and acrylic IOL implantation in children were retrospectively analyzed in 38 eyes of 28 children in age between 3 and 12 years. In all eyes primary posterior capsulotomy and anterior vitrectomy were performed. Thirty IOLs were implanted in the capsular bag, six IOLs were sulcus-fixated. All patients were examined on the first postoperative day, at 4-th and 8-th week and then every 6 months. The particular observations included the incidence of capsular bag fibrosis, cell deposits, haptic compression, corneal thickness and corneal endothelial density. Number of cell deposits were graded in three groups: 0 – fewer than 5 deposits, 1 – below than 10, 2 – more than 10 on the IOL surface. Results: Single piece acrylic IOLs were successfully implanted in 38 eyes. Incidence of transient postoperative inflammation was observed in 10 eyes. In 2 eyes postoperative inflammation was fairly high with fibrinous reaction. In all patients there were no postoperative opacification of the visual axis. Pigment or cell deposits were seen on the IOL surface in 0 group – 28 eyes, in 1 group – 8 eyes, in 2 group – 2 eyes. Central corneal thickness increased after surgery in 30 eyes (74%). There were no changes in endothelial cells counts and morphologic features in operated eyes. All IOLs remained anatomically stable and well centered during the mean follow-up of 18 months (range 6 to 27). Conclusions: Our results suggest that acrylic one-piece IOL implantation in children is a safe procedure with good and stable short-term anatomic results. This IOL appears clinically to be biocompatible when placed in the eyes of children despite the increased tissue reactivity known to occur in young patients. Longer follow-up is necessary to answer the questions about the long term safety of acrylic lens implantation in a child’s eye.
Słowa kluczowe: zaćma wrodzona, jednoczęściowa akrylowa soczewka wewnątrzgałkowa, depozyty komórkowe, biokompatybilność.
Keywords: congenital cataract, 1-piece flexible acrylic intraocular lens, cell deposits, biocompatibility.