Visual outcomes and complications in surgery for ectopia lentis in children

To evaluate postoperative visual acuity and complications in eyes with ectopia lentis having surgery with a sutured capsular tension ring (CTR) and intraocular lens (IOL).

St. Erik's Eye Hospital, Stockholm, Sweden.

Thirty-seven eyes of 22 children had surgery for lens dislocation. Two types of capsular rings were used; a Cionni modified CTR and a conventional CTR. In all cases, the rings were sutured to the sclera with a 10-0 polypropylene (Prolene) suture, the CTR and an AcrySof IOL (Alcon) were implanted in the capsular bag, and the posterior capsule was left intact. The preoperative and postoperative best corrected visual acuity (BCVA) and complications were studied retrospectively.

The mean age of the patients was 52 months. Thirty-three eyes had implantation of a Cionni modified CTR and 4 eyes, of a conventional CTR. The median preoperative BCVA (22 eyes) was 0.26 (range 0.015 to 0.65). The median postoperative BCVA (36 eyes) was 0.59 (range 0.2 to 1.0). The median follow-up period was 27 months (range 1 to 59 months). Twenty-six eyes had secondary surgery for visual axis opacification, with 5 eyes requiring 2 to 3 reoperations. Two eyes required secondary suturing for IOL decentration. Persistent amblyopia was observed in 3 eyes, with poor postoperative visual development. No eye had serious complications such as retinal detachment, endophthalmitis, or glaucoma.

Surgery for ectopia lentis with a CTR and an AcrySof IOL implanted in the capsular bag and sutured to the sclera appears to be safe in children.