Iris-claw intraocular lens implantation in children with ectopia lentis

Artisan iris-claw lens implantation (AICLI) is a surgical technique for treating ectopia lentis. We aimed to compare visual outcomes and possible long-term complications of AICLI surgery in pediatric patients with ectopia lentis with or without a diagnosable hereditary disease.

Methods:

Seventeen children with non-traumatic ectopia lentis were retros pectively classified into two groups: group 1 included children with a diagnosable hereditary disease (11 patients, 65%), and group 2 included children without any definable hereditary disease (six patients, 35%). Patients were evaluated for post-surgical refraction, best-corrected visual acuity, and clinical follow-up complications.

Results:

The average follow-up time was 38 months, and the average age of the patients was 103 ± 53 months (30-196 months). Best-corrected visual acuity values were significantly increased in both groups after surgery (p<0.05). Target refraction values were achieved at a rate of 47% in group 1 and 22% in group 2. Post-surgery complications, such as lens dislocation (36%, 11 eyes of 10 patients) and hypotonia (10%, three eyes of three patients) were observed in both groups, and retinal detachments (10%, three eyes of three patients) were observed in three patients from group 1.

Conclusions:

Compared with previous similar studies, this study utilized the largest pediatric patient group and had the longest post-surgery follow-up time. Moreover, it is advisable that pediatric patients with non-traumatic ectopia lentis be carefully screened for any underlying hereditary disease, especially diseases related to connective tissue metabolism.

Keywords:
Lens implantation, intraocular/methods; Lenses, intraocular; Marfan syndrome/complications; Homocystinuria; Ectopia lentis/surgery

Patient	Operated eye	Sex	Age (months)	Follow-up time	Preoperative BCVA (decimal)	Postoperative BCVA (decimal)	Hereditary disease	Postoperative complications	Reached the target refraction?
01	OD	M	060	32	0.05	0.80	Marfan	None	Y
	OS		068	24	0.05	0.80		Hypotonia	Y
02	OD	M	076	29	0.10	0.63	Marfan	ICL dislocation	N
	OS		073	32	0.10	0.40		ICL dislocation	N
03	OD	M	133	64	0.10	0.80	Marfan	None	Y
	OS		136	61	0.10	0.63		None	Y
04	OD	M	048	54	0.05	0.10	Marfan	ICL dislocation and retinal detachment	N
	OS		052	50	0.05	0.63		None	Y
05	OD	F	084	54	0.32	1.00	Marfan	None	N
	OS		090	48	0.32	0.80		None	Y
06	OD	M	183	33	0.05	0.10	Marfan	ICL dislocation and retinal detachment	N
	OS		186	30	0.10	0.40		None	Y
07	OD	F	180	52	0.20	0.80	Marfan	ICL dislocation	N
	OS		196	36	0.10	0.63		hypotonia	N
08	OD	F	030	41	0.05	0.80	Marfan	None	Y
	OS		036	35	0.05	0.63		ICL dislocation	Y
09	OD	F	078	17	0.10	0.40	Marfan	None	N
	OS		072	23	0.10	0.20		ICL dislocation	N
10	OD	M	055	12	0.05	0.01	Homocystinuria	ICL dislocation and retinal detachment	N
11	OD	F	061	19	0.05	0.40	Homocystinuria	None	Y
	OS		072	08	0.05	0.50		None	N
12	OS	M	122	70	0.02	0.32	None	ICL dislocation	N
13	OD	M	144	53	0.10	0.80	None	None	Y
	OS		155	42	0.10	0.80		None	N
14	OD	M	072	72	0.02	0.50	None	None	N
	OS		132	12	0.02	0.40		Hypotonia	N
15	OD	M	180	46	0.10	0.63	None	None	Y
	OS		196	30	0.10	0.63		None	N
16	OD	F	039	38	0.01	0.01	None	ICL dislocation	N
17	OS	M	090	48	0.01	0.01		ICL dislocation	N

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E-mail: abo@cbo.com.br

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[1] Corresponding author: Sadık Görkem Çevik. Sevket Yılmaz Reseach and Training Hospital - 29 ekim mah. No: 25 - Kumova residence B Blok D:27 - Bursa - 16120 - Turkey.