Outcomes of surgical intervention in cases of ectopia lentis

Abstract

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.

Ectopia Lentis: Clinical profiles in a large cohort of children from a Tertiary Eye Care network in India

“…including a cohort of 78 eyes concluded that pseudophakic eyes (32/78) in their series had better postoperative vision. [ 12 ] Fuerst et al . in a prospective series studied the artisan anterior chamber iris claw IOL outcomes in nontraumatic ectopia lentis in children.…”

Commentary: Outcomes of surgical intervention in cases of ectopia lentis

“…Surgical intervention in 78 eyes with ectopia lentis has been studied in a paper published in the current issue. [ 7 ] The authors describe the various surgical procedures and IOLs used in these cases. Their results show that overall visual outcome depends on the timing of the surgery, the type of surgery, the method of visual rehabilitation and compliance.…”