April 2014
Volume 55, Issue 13
Free
ARVO Annual Meeting Abstract  |   April 2014
Scleral-fixated Capsular Tension Rings and Segments for Ectopia Lentis in Children
Author Affiliations & Notes
  • Eric Joseph Kim
    Baylor College of Medicine, Houston, TX
  • James P Berg
    Baylor College of Medicine, Houston, TX
  • Mitchell P Weikert
    Ophthalmology, Cullen Eye Institute, Baylor College of Medicine, Houston, TX
  • Lingkun Kong
    Pediatric Ophthalmology, Texas Children's Hospital, Houston, TX
  • Marshall B Hamill
    Ophthalmology, Cullen Eye Institute, Baylor College of Medicine, Houston, TX
  • Douglas D Koch
    Ophthalmology, Cullen Eye Institute, Baylor College of Medicine, Houston, TX
  • Kimberly G Yen
    Ophthalmology, Cullen Eye Institute, Baylor College of Medicine, Houston, TX
    Pediatric Ophthalmology, Texas Children's Hospital, Houston, TX
  • Footnotes
    Commercial Relationships Eric Kim, None; James Berg, None; Mitchell Weikert, None; Lingkun Kong, None; Marshall Hamill, None; Douglas Koch, Abbott Medical Optics (C), Alcon Laboratories, Inc. (C); Kimberly Yen, None
  • Footnotes
    Support None
Investigative Ophthalmology & Visual Science April 2014, Vol.55, 4484. doi:
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      Eric Joseph Kim, James P Berg, Mitchell P Weikert, Lingkun Kong, Marshall B Hamill, Douglas D Koch, Kimberly G Yen; Scleral-fixated Capsular Tension Rings and Segments for Ectopia Lentis in Children. Invest. Ophthalmol. Vis. Sci. 2014;55(13):4484.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose: To report the short-term outcomes and complications of implantation of scleral-fixated capsular tension rings (CTR) and/or capsular tension segments (CTS) with intraocular lenses (IOL) in pediatric patients with ectopia lentis.

Methods: Retrospective, observational case series. Thirteen consecutive pediatric patients (20 eyes) underwent placement of in-the-bag IOL with either a Cionni modified CTR (M-CTR) or combined capsular tension ring and segment (CTR+CTS) between January 1, 2009 and March 30, 2013 by three anterior segment surgeons at a single academic center. The scleral fixation suture was 9-0 polypropylene in 17 eyes and CV-8 Gore-Tex (expanded polytetrafluoroethylene) in 3 eyes. Outcome measures included change in best-corrected visual acuity (BCVA) and complications.

Results: The mean age was 10.5 years ± 4.8 (SD) and the median follow-up, 16.1 months. M-CTR was implanted in 5 eyes and CTR+CTS in 14 eyes. In one eye, CTS only was placed due to a noncontinuous capsulorrhexis. The mean BCVA at the final follow-up (0.09 ± 0.11 logMAR, 19 eyes) was significantly better than preoperatively (0.55 ± 0.27 logMAR, 16 eyes) (P < 0.001). The BCVA at the final follow-up was 20/40 or better in 19 eyes (95%). All IOLs were well-centered. Posterior capsular opacification developed in 10 eyes (50%); 8 eyes (40%) required Nd:YAG capsulotomy and 3 eyes (15%) required pars plana vitrectomy and posterior capsulotomy. Other complications included broken suture (5%) (9-0 polypropylene at CTR eyelet; repaired with CV-8 Gore-Tex), conjunctival dehiscence (5%), suture exposure (5%) (transcleral 9-0 polypropylene), and vitreous strand at inferior paracentesis (5%). There were no cases of post-operative IOL subluxation.

Conclusions: Implantation of in-the-bag IOL with either the M-CTR or CTR+CTS is a safe and effective technique for visual rehabilitation in pediatric ectopia lentis.

Keywords: 462 clinical (human) or epidemiologic studies: outcomes/complications • 567 intraocular lens  
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