INTRAOCULAR LENS IMPLANTATION IN PEDIATRIC EYES WITH POSTERIOR LENTIGLOBUS

Purpose: To report the outcome of intraocular lens (IOL) implantation in pediatric eyes with posterior lentiglobus. Methods: Retrospective chart review of pediatric cataract surgery cases with primary IOL implantation. Results: Of 553 eyes that received IOL implantation by the lead author, 364 eyes were identified as having been implanted with an IOL at the time of surgery for a nontraumatic cataract. Nineteen (5.2%) of 364 eyes were diagnosed with posterior lentiglobus. The average age at surgery was 5.8 ± 3.8 years (range, 0.6 to 13.9) years. All eyes had monocular cataract. Gender and ethnic distribution were as follows: male-female ratio, 12:7, and African American–Caucasian ratio, 4:15. A preexisting posterior capsule tear was noted at surgery in eight eyes, six of which presented with leukocoria from white cataracts. Site of IOL implantation was as follows: in-the-bag in 14 and sulcus in five, with optic capture into the anterior and posterior capsulotomy in four of those five. The average postoperative follow-up was 3.7 ± 3.0 years. Median postoperative visual acuity was 20/30, and postoperative strabismus was noted in five eyes. Secondary surgery was required in one eye for visual axis opacification and one eye for lysis of synechiae (diagnosed with postoperative spike in intraocular pressure). No other intraoperative or postoperative complications were observed. Conclusion: Posterior lentiglobus causes a progressive unilateral cataract. Spontaneous rupture can result in leukocoria from a total white cataract. IOL implantation with posterior lentiglobus provided a satisfactory outcome in children. Trans Am Ophthalmol Soc 2006:104:176-18