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Scleral-fixated intraocular lenses improve visual acuity and show low complication rates in pediatric eyesDifferent types of scleral lens fixation improve vision for children

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Key Takeaway
Note that all scleral-fixated intraocular lens types improve visual acuity with low complication rates for sutureless models.

This meta-analysis evaluates the clinical performance of various scleral-fixated intraocular lenses (SFIOLs), including glued (GSFIOLs), sutureless (SLSFIOLs), and sutured (SSFIOLs) types, in a pediatric population of 1531 eyes. The study focuses on primary outcomes of visual acuity, refraction, and intraocular pressure (IOP).

Analysis of visual acuity showed improvement from a preoperative mean of 0.75 ± 0.50 SD logMAR to a postoperative mean of 0.39 ± 0.19 SD logMAR. The mean spherical equivalent was reported as 0.59 ± 0.91. While all SFIOL types showed improvement in initial outcomes, specific safety data highlighted that SLSFIOLs and Gore-Tex SSFIOLs had low complication rates.

Safety data for polypropylene SSFIOLs included transient high IOP (8.1%), suture break or erosion (1.19%), glaucoma (0.31%), and corneal decompensation (0.15%). GSFIOLs showed a 5.3% reoperation rate for IOL repositioning. The authors note that suture erosion was not reported specifically for Gore-Tex SSFIOLs. These findings suggest that while all SFIOL types are effective for initial outcomes, specific materials and fixation methods may influence complication profiles in pediatric patients.

When a child needs a special lens to see clearly, the way that lens is held in place matters. Doctors use several methods to fix these lenses, including using glue, sutures (threads), or sutureless designs. This study looked at over 1,500 eyes in children aged 1 to 18 to see how these different techniques performed.

Researchers found that all three types of lens fixation helped improve vision compared to the state before surgery. The results showed a clear improvement in visual acuity for every group. While some methods had slightly higher risks for issues like high eye pressure or suture problems, others were noted for having very low complication rates.

Because each method has different safety profiles, choosing the right one depends on the specific needs of the child. For example, while all types improved vision, certain materials and designs showed fewer complications over time. Parents and doctors can now look at these results to better understand how different lens fixations perform in pediatric patients.

What this means for you:
All three types of scleral lens fixation successfully improve vision for children with complex eye needs.

Common questions

Do these different lens types actually improve a child's vision?

Yes. The study looked at 1,531 eyes in children aged 1 to 18 and found that all three types of scleral-fixated intraocular lenses improved visual acuity compared to the measurements taken before surgery.

Are there any safety concerns with these lens fixations?

Some risks exist depending on the method. For example, polypropylene sutured lenses had a 8.1% rate of high eye pressure and a 1.19% rate of suture break or erosion. However, sutureless and Gore-Tex options were noted for having low complication rates.

What are the different ways to fix these lenses in children?

The study compared three main methods: glued lenses (GSFIOLs), sutureless lenses (SLSFIOLs), and sutured lenses (SSFIOLs) which use materials like polypropylene or Gore-Tex. All three types showed improvement in initial outcomes for the patients.

Study Details

Study typeMeta analysis
Sample sizen = 75
EvidenceLevel 1
Follow-up216.0 mo
PublishedJul 2026
View Original Abstract ↓
PURPOSE: To compare the outcomes of scleral-fixated intraocular lenses (SFIOLs) in the paediatric population. We included sutureless scleral-fixated intraocular lenses (SLSFIOLs), glued scleral-fixated intraocular lenses (GSFIOLs) and sutured scleral-fixated intraocular lenses (SSFIOLs) using polypropylene and Gore-Tex sutures. METHODS: A systematic review and meta-analysis were performed in line with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. An electronic search was performed to include studies from 1999 to 2023. We included 1-18-year-old studies. The analysis was based on fixed and random-effect models. Primary outcomes included visual acuity, refraction and intraocular pressure (IOP). Secondary outcomes were lens tilt and extrusion of suture material. RESULTS: 33 studies (1531 eyes) were included (GSFIOLs n=75, SLSFIOLs n=162, SSFIOLs n=1294 (Gore-Tex n=30 and polypropylene n=1264)). Vision improved from preoperative (mean 0.75±0.50 SD) to postoperative (mean 0.39±0.19 SD) logarithm of the minimal angle of resolution. The mean spherical equivalent was 0.59±0.91. Transient high IOP post-OP was highest among polypropylene SSFIOLs, 8.1%. Polypropylene SSFIOLs had glaucoma in 0.31% and corneal decompensation in 0.15%. A suture break or erosion was reported in 1.19%. None of the other groups developed glaucoma or corneal decompensation. Suture erosion was not reported in Gore-Tex SSFIOLs. GSFIOLs had a 5.3% reoperation rate, mostly for IOL repositioning. CONCLUSION: All types of scleral lens fixation showed improvement in initial outcomes. SLSFIOLs and Gore-Tex SSFIOLs have low complication rates.
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