Outcomes of Four‐Point Sutured Scleral‐Fixated Intraocular Lens Implantation Using Gore‐Tex Suture in Paediatric Eyes

Background Intraocular lens implantation in children with insufficient zonular support can be challenging. Scleral‐fixated intraocular lens (SFIOL) implantation can be useful in these cases. We aim to report the visual and refractive outcomes of four‐point sutured SFIOL in children. Methods A retrospective review of children who underwent primary or secondary four‐point SFIOL using Akreos AO60 or Luxgood intraocular lens with polytetrafluoroethylene monofilament (PTFE, Gore‐Tex) at Queensland Children's Hospital, Brisbane, Australia. Results Fifty‐three eyes of 31 children were included for review. The mean age of SFIOL implantation was 7.86 ± 3.71 years. The median follow‐up time was 24 months (IQR 35, range 1–77). The majority of children had subluxed crystalline lenses secondary to Marfan syndrome (44 eyes, 83.02%). Best corrected visual acuity (BCVA) was maintained or improved from the preoperative BCVA in 92.6% of eyes. Median postoperative BCVA improved to logMAR 0.2 (IQR 0.16) at 1‐year follow‐up ( p < 0.01). Compared to target refraction, the postoperative refraction was more myopic, but this was not statistically significant. In 33 eyes that had more than 1 year of follow‐up, residual refractive error was within 1.00D for 21 eyes, within 2.00D for 7 eyes, within 3.00D for 3 eyes and greater than 3.00D for 2 eyes. Retinal detachment occurred in three eyes (5.66%). Asymptomatic IOL tilt/decentration was noted in one eye (1.88%). Conclusions Four‐point SFIOL implantation using Gore‐Tex suture offered excellent visual and refractive outcomes. Postoperative complications were rare and there were no new cases of amblyopia during the follow‐up period.