Ectopic lens extraction in children

Ectopia lentis continues to be a therapeutic challenge for ophthalmologists. It can occur as an isolated condition, after ocular trauma, in association with other ocular disorders, as part of a systemic mesodermal disease or as a complication of general metabolic disorders. Minimal subluxation of the lens may cause no visual symptoms, but in more advanced cases serious optical disturbances arise. The most important is amblyopia. Surgical treatment options include iris manipulation, lens decision, aspiration, intracapsular or extracapsular extraction, and pars plana lensectomy. The choice of surgical technique remains controversial because of poor visual results and high rate of perioperative complications, including vitreous loss and retinal detachment. We describe a surgical technique based on the use of the Cionni endocapsular tension ring, dry irrigation aspiration of lens material, centering of the capsular bag and foldable intraocular lens implantation into the bag. Eight patients were surgically treated with this surgical technique (4 boys and 4 girls, all together 11 eyes). The final BCVA after the follow-up period improved in 9 patients and it remained the same as before operation in one patient. Statistical comparison of preoperative and postoperative visual acuities showed significant improvement. On the other hand, there was no correlation between preoperative and postoperative visual acuity. This surgical procedure is an alternative approach in solving the challenging cases of ectopia lentis with good postoperative visual rehabilitation.