PMID- 34653355
OWN - NLM
STAT- MEDLINE
DCOM- 20220411
LR  - 20220411
IS  - 1879-1891 (Electronic)
IS  - 0002-9394 (Linking)
VI  - 236
DP  - 2022 Apr
TI  - In-the-Bag Versus Ciliary Sulcus Secondary Intraocular Lens Implantation for 
      Pediatric Aphakia: A Prospective Comparative Study.
PG  - 183-192
LID - S0002-9394(21)00522-5 [pii]
LID - 10.1016/j.ajo.2021.10.006 [doi]
AB  - PURPOSE: To compare outcomes of in-the-bag vs ciliary sulcus secondary 
      intraocular lens (IOL) implantation for pediatric aphakia. DESIGN: Prospective 
      interventional case series. METHODS: This institutional study was conducted in 
      202 children (355 aphakic eyes) diagnosed as having congenital cataracts and who 
      underwent cataract extraction before age 24 months. Pediatric aphakic eyes 
      underwent in-the-bag or ciliary sulcus secondary IOL implantation according to 
      the amount of residual lens capsule and were monitored for 3 years 
      postoperatively. The main outcome measures were adverse events (AEs), IOL tilt 
      and decentration, and best corrected visual acuity (BCVA) in the operative eye. 
      RESULTS: A total of 144 eyes (40.6%, 89 children) received in-the-bag IOL 
      implantation (capsular group), and 211 eyes (59.4%, 132 children) underwent 
      ciliary sulcus IOL implantation (sulcus group). Kaplan-Meier curves showed that 
      the time-dependent incidence of glaucoma-related AEs (GRAEs) (P = .005) and any 
      AEs (P = .002) were higher in the sulcus group. In-the-bag IOL implantation was a 
      strong protective factor against GRAE (hazard ratio, 0.08; 95% CI, 0.01-0.53; 
      P = .009) and any AEs (hazard ratio, 0.21; 95% CI, 0.08-0.57; P = .002). 
      Clinically significant IOL decentration (>0.4 mm) was more common in the sulcus 
      group compared with the capsular group (vertical decentration: 29.8% vs 15.7%, 
      P = .005; horizontal decentration: 30.3% vs 9.35%, P < .001). BCVA in the 
      capsular group was better than that in the sulcus group (logMAR, 0.56 vs 0.67, 
      P = .014). CONCLUSIONS: Compared with ciliary sulcus secondary IOL implantation, 
      in-the-bag IOL implantation reduced AEs and yielded better IOL centration and 
      BCVA for pediatric aphakia.
CI  - Copyright (c) 2021 The Author(s). Published by Elsevier Inc. All rights reserved.
FAU - Liu, Zhenzhen
AU  - Liu Z
AD  - Zhongshan Ophthalmic Center (Z.L., H.L., G J., X.T., B.Q., L.J., X.C., W.W., X. 
      H., J.X., M.H., N.C., W.C., L.L., Y.L.) State Key Laboratory of Ophthalmology, 
      Sun Yat-sen University, Guangzhou, Guangdong, China.
FAU - Lin, Haotian
AU  - Lin H
AD  - Zhongshan Ophthalmic Center (Z.L., H.L., G J., X.T., B.Q., L.J., X.C., W.W., X. 
      H., J.X., M.H., N.C., W.C., L.L., Y.L.) State Key Laboratory of Ophthalmology, 
      Sun Yat-sen University, Guangzhou, Guangdong, China.
FAU - Jin, Guangming
AU  - Jin G
AD  - Zhongshan Ophthalmic Center (Z.L., H.L., G J., X.T., B.Q., L.J., X.C., W.W., X. 
      H., J.X., M.H., N.C., W.C., L.L., Y.L.) State Key Laboratory of Ophthalmology, 
      Sun Yat-sen University, Guangzhou, Guangdong, China.
FAU - Tan, Xuhua
AU  - Tan X
AD  - Zhongshan Ophthalmic Center (Z.L., H.L., G J., X.T., B.Q., L.J., X.C., W.W., X. 
      H., J.X., M.H., N.C., W.C., L.L., Y.L.) State Key Laboratory of Ophthalmology, 
      Sun Yat-sen University, Guangzhou, Guangdong, China.
FAU - Qu, Bo
AU  - Qu B
AD  - Zhongshan Ophthalmic Center (Z.L., H.L., G J., X.T., B.Q., L.J., X.C., W.W., X. 
      H., J.X., M.H., N.C., W.C., L.L., Y.L.) State Key Laboratory of Ophthalmology, 
      Sun Yat-sen University, Guangzhou, Guangdong, China.
FAU - Jin, Ling
AU  - Jin L
AD  - Zhongshan Ophthalmic Center (Z.L., H.L., G J., X.T., B.Q., L.J., X.C., W.W., X. 
      H., J.X., M.H., N.C., W.C., L.L., Y.L.) State Key Laboratory of Ophthalmology, 
      Sun Yat-sen University, Guangzhou, Guangdong, China.
FAU - Chen, Xiaoyun
AU  - Chen X
AD  - Zhongshan Ophthalmic Center (Z.L., H.L., G J., X.T., B.Q., L.J., X.C., W.W., X. 
      H., J.X., M.H., N.C., W.C., L.L., Y.L.) State Key Laboratory of Ophthalmology, 
      Sun Yat-sen University, Guangzhou, Guangdong, China.
FAU - Wang, Wei
AU  - Wang W
AD  - Zhongshan Ophthalmic Center (Z.L., H.L., G J., X.T., B.Q., L.J., X.C., W.W., X. 
      H., J.X., M.H., N.C., W.C., L.L., Y.L.) State Key Laboratory of Ophthalmology, 
      Sun Yat-sen University, Guangzhou, Guangdong, China.
FAU - Han, Xiaotong
AU  - Han X
AD  - Zhongshan Ophthalmic Center (Z.L., H.L., G J., X.T., B.Q., L.J., X.C., W.W., X. 
      H., J.X., M.H., N.C., W.C., L.L., Y.L.) State Key Laboratory of Ophthalmology, 
      Sun Yat-sen University, Guangzhou, Guangdong, China.
FAU - Xu, Jingmin
AU  - Xu J
AD  - Zhongshan Ophthalmic Center (Z.L., H.L., G J., X.T., B.Q., L.J., X.C., W.W., X. 
      H., J.X., M.H., N.C., W.C., L.L., Y.L.) State Key Laboratory of Ophthalmology, 
      Sun Yat-sen University, Guangzhou, Guangdong, China.
FAU - Ying, Guishuang
AU  - Ying G
AD  - Department of Ophthalmology (G.Y.), Perelman School of Medicine, University of 
      Pennsylvania, Philadelphia, Pennsylvania, USA.
FAU - Han, Ying
AU  - Han Y
AD  - Department of Ophthalmology (Y.H.), University of California, San Francisco, San 
      Francisco, California, USA.
FAU - He, Mingguang
AU  - He M
AD  - Zhongshan Ophthalmic Center (Z.L., H.L., G J., X.T., B.Q., L.J., X.C., W.W., X. 
      H., J.X., M.H., N.C., W.C., L.L., Y.L.) State Key Laboratory of Ophthalmology, 
      Sun Yat-sen University, Guangzhou, Guangdong, China.
FAU - Congdon, Nathan
AU  - Congdon N
AD  - Zhongshan Ophthalmic Center (Z.L., H.L., G J., X.T., B.Q., L.J., X.C., W.W., X. 
      H., J.X., M.H., N.C., W.C., L.L., Y.L.) State Key Laboratory of Ophthalmology, 
      Sun Yat-sen University, Guangzhou, Guangdong, China; Center for Public Health 
      (N.C.), Queen's University Belfast, Belfast, United Kingdom; Orbis International 
      (N.C.), New York, New York, USA.
FAU - Chen, Weirong
AU  - Chen W
AD  - Zhongshan Ophthalmic Center (Z.L., H.L., G J., X.T., B.Q., L.J., X.C., W.W., X. 
      H., J.X., M.H., N.C., W.C., L.L., Y.L.) State Key Laboratory of Ophthalmology, 
      Sun Yat-sen University, Guangzhou, Guangdong, China.
FAU - Luo, Lixia
AU  - Luo L
AD  - Zhongshan Ophthalmic Center (Z.L., H.L., G J., X.T., B.Q., L.J., X.C., W.W., X. 
      H., J.X., M.H., N.C., W.C., L.L., Y.L.) State Key Laboratory of Ophthalmology, 
      Sun Yat-sen University, Guangzhou, Guangdong, China. Electronic address: 
      luolixia@gzzoc.com.
FAU - Liu, Yizhi
AU  - Liu Y
AD  - Zhongshan Ophthalmic Center (Z.L., H.L., G J., X.T., B.Q., L.J., X.C., W.W., X. 
      H., J.X., M.H., N.C., W.C., L.L., Y.L.) State Key Laboratory of Ophthalmology, 
      Sun Yat-sen University, Guangzhou, Guangdong, China. Electronic address: 
      liuyizh@mail.sysu.edu.cn.
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20211013
PL  - United States
TA  - Am J Ophthalmol
JT  - American journal of ophthalmology
JID - 0370500
SB  - IM
MH  - *Aphakia, Postcataract/etiology/surgery
MH  - *Cataract Extraction/adverse effects
MH  - Child
MH  - Child, Preschool
MH  - Humans
MH  - *Lens Capsule, Crystalline/surgery
MH  - Lens Implantation, Intraocular/adverse effects
MH  - *Lenses, Intraocular/adverse effects
MH  - Prospective Studies
EDAT- 2021/10/16 06:00
MHDA- 2022/04/12 06:00
CRDT- 2021/10/15 20:10
PHST- 2021/07/08 00:00 [received]
PHST- 2021/10/03 00:00 [revised]
PHST- 2021/10/06 00:00 [accepted]
PHST- 2021/10/16 06:00 [pubmed]
PHST- 2022/04/12 06:00 [medline]
PHST- 2021/10/15 20:10 [entrez]
AID - S0002-9394(21)00522-5 [pii]
AID - 10.1016/j.ajo.2021.10.006 [doi]
PST - ppublish
SO  - Am J Ophthalmol. 2022 Apr;236:183-192. doi: 10.1016/j.ajo.2021.10.006. Epub 2021 
      Oct 13.