Prospective analysis of Artisan aphakia intraocular lens implantation for nontraumatic ectopia lentis in children

Abstract

To report long-term outcomes of iris claw aphakia intraocular lens (IOL) implantation for nontraumatic ectopia lentis (EL) in children. In this prospective study, children who underwent Artisan Aphakia IOL placement were included if they have a minimum of 1-year follow-up after implantation. Main outcome measures were: best-corrected distance visual acuity, reoperations, change in central corneal thickness (CCT), and corneal endothelial cell counts (ECC). The Artisan Aphakia IOL was implanted in a total of 76 eyes of 43 patients (68 eyes of 34 patients with EL). 56 eyes of 28 patients have been followed long enough to meet the inclusion criteria for this report. The average age at Artisan Aphakia IOL implantation was 11.1 years (range of 2-20 years). Average follow-up was 3.59 years, and 23% of patients have >5 years' follow-up. Mean best-corrected visual acuity improved from 0.36 (20/46) to logMAR 0.18 (20/30) after implantation (P = 0.02). Five reoperations were needed in 4 patients, 3 (7%) related to post-implantation trauma. Average preoperative CCT was 580 μm; estimated mean increase in CCT at the 5-year postoperative visit was 11.9 μm higher (P = 0.047). Average preoperative ECC was 3178 cells/mm2; estimated mean loss of ECC at the 5-year postoperative visit was not significantly different from zero (187.7 cells/mm2 [P = 0.102]). The Artisan Aphakia IOL, used in the absence of capsular support, had an acceptable safety profile in our patients.