Abstract
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. 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. 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. 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.
Highlights
Objetivo: A implantação de lentes intraoculares de fixação iriana em garra (AICLI) é uma técnica cirúrgica para o tratamento de ectopia lentis
Ectopia lentis is a condition in which the lens is displaced due to loose or broken lens zonules
Whenever ectopia lentis without evident trauma is observed in a clinical setting, the possibility of co-existing genetic diseases should be considered, especially those related to connective tissue metabolism, such as Marfan syndrome, homocystinuria, Weill-Marchesani syndrome, hyperlysinemia, and sulfite oxidase deficiency[1,2]
Summary
Ectopia lentis is a condition in which the lens is displaced due to loose or broken lens zonules. If the crystal lens is mildly displaced, treatment should involve vision and amblyopia correction as the first choice. The primary choice might be “in-the-bag” placement of a posterior chamber intrao cular lens, provided that the patient is at least 2 years old and that capsular support is present[4,5]. In the absence of capsular support, surgical options vary depending on the surgeon’s choice and may include iris-fixated or angle-supported anterior chamber intraocular lens, scleral-fixated intraocular lens (IOL), glued intrascleral-fixated IOL[6,7], and Artisan iris-claw lens implantation (ICL)(8) techniques. We prefer the Artisan iris-claw lens implantation (AICLI) technique, which places an iris-claw lens behind (posterior to) the iris in the absence of capsular support
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