Lensectomy for Ectopia Lentis
Sarah A. Logan; Leah A. Bonaparte; Rupal Trivedi; M. Edward Wilson
Medical University of South Carolina
Charleston, South Carolina
Introduction: The management of ectopia lentis is complex. We report herein the outcomes of a consecutive case series of children after lensectomy for ectopia lentis.
Methods: Retrospective study of patients who underwent lensectomy for ectopia lentis between January 1, 1996 to July 31, 2017 at one institution. Patient characteristics, refractive outcomes, and surgical details were collected. Endpoints included postoperative complications and associated eye conditions that developed during the follow up period.
Results: 124 eyes of 64 patients (21 female, 43 male) were included. 60 patients were operated bilaterally and 4 had unilateral surgery. 69 eyes belonged to patients with a diagnosis of Marfan syndrome, 6 eyes from children with other systemic diagnoses, and 49 eyes from children with an unknown diagnosis. The mean age at surgery was 6.88 years. After lensectomy, 69.4% were aphakic (27.4% received secondary IOL) while 30.6% underwent primary IOL implantation. The mean follow up was 5.16 years. The median visual acuity was 20/30. Complications included visual axis opacification requiring surgery in 6 eyes, glaucoma in 15 eyes, and retinal detachment in 4 eyes. In 6 eyes, an angle-supported ACIOL rotated after years of stability and was exchanged for an iris-claw IOL. Two of these eyes, from 1 patient, developed cystoid macular edema that resolved after IOL exchange.
Discussion: Visual axis opacification, glaucoma, retinal detachment, and IOL rotation were the most common postoperative complications.
Conclusion: This study adds to the current understanding of long-term visual outcomes and complications of children with lensectomy for ectopia lentis.
References: 1. Simon MA, Origlieri CA, Dinallo AM, et al. New Management Strategies for Ectopia Lentis. J Pediatr Ophthalmol Strabismus. 2015 Sep-Oct; 52(5): 269-81.