Intra-lenticular lens aspiration in paediatric cases with anterior dislocation of lens

Sahay, Pranita; Maharana, Prafulla K.; Shaikh, Nawazish; Goel, Shubhi; Sinha, Rajesh; Agarwal, Tushar; Titiyal, Jeewan S

doi:10.1038/s41433-019-0426-y

Cited by 5 publications

(3 citation statements)

References 9 publications

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“…Lens subluxation in children is more often performed using ICCE surgery. [9] ICCE is the leading choice in cases of bilateral subluxation due to several syndromes in children. Myopia can develop from increased lens curvature caused by subluxated lenses.…”

Section: Discussionmentioning

confidence: 99%

Isolated Ectopia Lentis in Suspect of Weill-Marchesani Syndrome (WMS)

Arrachman

Sekartika²,

Khanza³

et al. 2022

VSEHJ

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Introduction: The prevalence of Weill-Marchesani syndrome (WMS) is estimated to be 1:100.000 proportion of the population. Knowledge of the clinical and therapy of WMS is expected to improve the ability to diagnose this disease. In this case report, we will present a case of WMS in a tertiary hospital because our findings are rare and essential concerning the symptomatic treatment and visual rehabilitation. Case Presentation: A 7-year-old child presented with blurred vision in the left eye. The patient showed an abnormal facial appearance with short stature and brachydactyly on both hands. The patient had a history of Intracapsular cataract extraction (ICCE) surgery on the right eye with an indication of anterior lens subluxation. The patient then suffered aphakic glaucoma in the right eye after surgery. Anterior segment examination of the right eye found an aphakic lens, conjunctival sclerectasia, atrophic iris, and mid-dilation pupil. Anterior segment of the left eye found an atrophic iris and lens subluxation. From the clinical appearance and the ocular disturbance, such as brachydactyly and short stature, the patient was diagnosed with suspected WMS. The patient was treated with ICCE surgery on the left eye and micropulse transscleral cyclophotocoagulation (MP-TSCPC) surgery on the right eye. Conclusion: WMS is a rare disease. It is essential to make an early diagnosis of glaucoma and ectopia lentis in WMS patients because it will affect their vision.

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Section: Discussionmentioning

confidence: 99%

Isolated Ectopia Lentis in Suspect of Weill-Marchesani Syndrome (WMS)

Arrachman

Sekartika²,

Khanza³

et al. 2022

VSEHJ

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“…All cases had undergone cataract surgery using a standardized technique under GA as published in one of the papers from our center. [ 2 ] Intra-lenticular lens aspiration (ILLA) with anterior vitrectomy was performed for ectopia lentis cases only as described in one of our previous papers. [ 3 ] All cases were followed up at our lens clinic.…”

Section: Methodsmentioning

confidence: 99%

Cataract surgery outcomes in pediatric patients with systemic comorbidities

Mandal

Maharana

Nagpal

et al. 2022

Indian Journal of Ophthalmology

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Purpose: The aim of the study was to evaluate the outcomes of cataract surgery in patients of the pediatric age group with systemic comorbidities. Methods: Medical records of 54 eyes (30 patients) of the pediatric age group with systemic comorbidities who had undergone cataract surgery in a tertiary-care center were reviewed. The following parameters were recorded: systemic comorbidity; toxoplasmosis, rubella, cytomegalovirus, herpes simplex, HIV (TORCH) profile, best spectacle-corrected visual acuity (BSCVA), strabismus, nystagmus, and cataract morphology. Results: Thirty patients with a mean age of 55 months (9 months–14 years) were included. On average, every child was seen by three physicians, and the mean duration between the first visit to a physician and presentation to our center was 2.23 ± 0.67 years. The various causes for delay in referral include multiple referrals due to a lack of general anesthesia services in 78% of cases, a long waiting list at the referral hospital in 35% of cases, and a lack of awareness at the primary-care physician level in 50% of cases. The mean BSCVA at presentation was 1.4 logMAR (0.3 to 3 logMAR). The most common cataract morphology was that of zonular cataract (31.48%; 17/54). Strabismus and abnormal eye movements were observed in 27.7% (15/54) and 33.3% (18/54) of eyes, respectively. Various systemic associations were periventricular leukomalacia (12/30), Down’s syndrome (6/30), seizure disorder (6/30), cardiac valvular anomalies (6/30), Marfan’s syndrome (4/30), hypothyroidism (4/30), rubella (3/20), cytomegalovirus (3/20), cerebral palsy (2/30), nephrotic syndrome (2/30), Type 1 diabetes mellitus (1/30), microcephaly (1/30), cryptogenic West syndrome (1/30), congenital rubella syndrome (1/30), and Tourette syndrome (1/30). The mean postoperative corrected distance visual acuity (CDVA) at 2-year follow-up improved to 1.0 logMAR (0 to 3 logMAR). No postoperative complications were reported at the final follow-up. Around 70% of the parents reported improvement in their child’s psychomotor skills. Conclusion: Intellectually impaired pediatric patients with cataract should be operated upon whenever there is a presence of infrastructure, and unnecessary delay in surgery should be avoided by referring the patient to higher centers. Even though objective improvement in visual acuity was suboptimal, there was definitely an improvement in the psychomotor skills of the patients.

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“…The various surgical techniques described in the literature for the management of subluxated lenses include lensectomy (limbal/pars plana), lens aspiration, in the bag bimanual irrigation-aspiration of the lens, phaco-aspiration, intra-lenticular lens aspiration (ILLA), and intra-capsular cataract extraction (ICCE). [ 3 4 5 6 7 8 ] The options for intra-ocular lens (IOL) implantation in these cases include anterior chamber IOL (ACIOL), iris clawed IOL, scleral-fixated IOL (SFIOL), and posterior chamber IOL (PCIOL) with capsular supporting devices.…”

mentioning

confidence: 99%

Outcomes of surgical intervention in cases of ectopia lentis

Maharana

Sahay²,

Mandal³

et al. 2022

Indian Journal of Ophthalmology

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Purpose: To evaluate the outcomes of surgical intervention in cases of ectopia lentis. Methods: This retrospective study included all cases of ectopia lentis that presented between June 2015 and March 2019 in a tertiary care center. They were reviewed retrospectively. The corrected distance visual acuity (CDVA), severity of lens subluxation, type of surgery, intra-operative and post-operative complication, and specular count were recorded. Results: Seventy-eight eyes of 57 cases with a mean age at surgery of 14.73 years were analyzed. Intra-lenticular lens aspiration was the most common (n-62/78; 79.5%) surgical procedure followed by lens aspiration, intra-capsular cataract extraction, phaco-aspiration, and pars-plana lensectomy. Simultaneous intra-ocular lens (IOL) implantation was performed in 46.2% (n-32/78) of the eyes. The mean CDVA improved from 0.85 ± 0.55 logMAR to 0.44 ± 0.29 logMAR at 6 weeks follow-up. The post-operative CDVA was significantly better in the pseudo-phakic group compared to the aphakic group (p-0.02). The patient’s age at the time of surgery and the degree of subluxation did not impact the final visual outcome. Intra-operative complication included vitreous hemorrhage (n-1) and lens matter drop (n-1). Post-operative complications were noted in 26.9% of the eyes (n-21/78) with a higher complication rate in the pseudo-phakic group (p-0.00). A second intervention was required in 7.7% of the eyes (n-6/78). Conclusion: Age and degree of subluxation at the time of surgery do not influence the final visual outcome in cases of ectopia lentis undergoing lens extraction surgery. IOL implantation results in better visual outcomes but is associated with a high complication rate.

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Intra-lenticular lens aspiration in paediatric cases with anterior dislocation of lens

Cited by 5 publications

References 9 publications

Isolated Ectopia Lentis in Suspect of Weill-Marchesani Syndrome (WMS)

Isolated Ectopia Lentis in Suspect of Weill-Marchesani Syndrome (WMS)

Cataract surgery outcomes in pediatric patients with systemic comorbidities

Outcomes of surgical intervention in cases of ectopia lentis

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