Long-Term Outcomes after Surgery for Congenital Lens Subluxation

Abstract

Objective: To assess the long-term outcome and complications profile of primary scleral-fixated posterior chamber intraocular lenses in patients with congenital lens subluxation. Methods: In this retrospective case series study, all patients who had undergone lens surgery between January 2005 and June 2014 were reviewed for visual outcomes and complications. Demographic data and information on baseline preoperative best corrected visual acuity (BCVA), intraocular pressure (IOP) before surgery, indication for surgery, intraoperative complications, postoperative complications, last postoperative visual acuity, intraocular lens position, and indication for any subsequent surgical procedures were collected and analyzed using paired t-tests and independent t-tests. Results: Patients mean age at surgery was 23±20 years (5 to 67 years), with a mean follow-up of 38±26 months (12 to 130 months). For the 77 eyes included, the mean preoperative BCVA (LogMAR) was 0.84±0.55, which improved significantly to 0.26±0.43 postoperatively (t=8.55, P<0.001). IOP decreased only in patients with spherophakia. Complications included transient intraocular hemorrhage (2 eyes, 2.6%), early vitreous incarceration (2 eyes, 2.6%), retinal detachment (6 eyes, 7.8%), and intraocular lens dislocation (1 eye, 1.3%). Conclusions: Based on long-term follow-up data, primary scleral-fixated posterior chamber intraocular lenses can significantly improve visual acuity in patients with congenital lens subluxation. However, ophthalmologists should be alert for potential long-term postoperative complications. Key words: congenital lens subluxation; lensectomy; primary scleral-fixated posterior chamber intraocular lenses; treatment outcome; complication