Complication of foldable single-piece intraocular lens sulcus implantation in a child under two years old

Abstract

A two-and-a-half-year-old boy presented to Cipto Mangunkusumo Hospital, Jakarta, Indonesia with a white spot on his left eye. He had cataract surgery one year prior at another hospital. On examination, corectopia, anterior synechiae, white plaque between the iris and corneal endothelium, a shallow anterior chamber, and an intraocular lens (IOL) in the posterior chamber were found. As a result, anterior chamber reformation and IOL explantation was performed.

Intraoperatively, a foldable single-piece IOL was found in the ciliary sulcus. Hence, extreme inflammatory process after the operation was unavoidable. One month after the procedure, the cornea was opaque without an increase in intraocular pressure. It is recommended to perform IOL implantation only in children over two years of age with a corneal diameter more than 9 mm. A three-piece IOL might be implanted in the area of the ciliary sulcus only if the child needs an immediate IOL implant.