May 2007
Volume 48, Issue 13
Free
ARVO Annual Meeting Abstract  |   May 2007
Surgical Management of Ectopia Lentis in Children
A. C. Kopel; P. E. Carvounis; E. R. Holz
Author Affiliations & Notes
  • A. C. Kopel
    Ophthalmology, baylor college of medicine, Houston, Texas
  • P. E. Carvounis
    Ophthalmology, Baylor College of Medicine, Houston, Texas
  • E. R. Holz
    Ophthalmology, Baylor College of Medicine, Houston, Texas
  • Footnotes
    Commercial Relationships A.C. Kopel, None; P.E. Carvounis, None; E.R. Holz, None.
  • Footnotes
    Support None.
Investigative Ophthalmology & Visual Science May 2007, Vol.48, 2242. doi:
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      A. C. Kopel, P. E. Carvounis, E. R. Holz; Surgical Management of Ectopia Lentis in Children. Invest. Ophthalmol. Vis. Sci. 2007;48(13):2242.

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Abstract

Purpose:: To compare outcomes and complications of pars plana lensectomy-vitrectomy for the management of ectopia lentis in children with or without an iris-fixated intraocular lens.

Methods:: Retrospective, interventional, comparative series of consecutive patients at Baylor College of Medicine, operated on by a single-vitreoretinal surgeon comprising 22 eyes with ectopia lentis in 12 pediatric patients who underwent pars plana lensectomy-vitrectomy with or without intraocular lens insertion (iris fixated) between June 1998 and October 2006. The primary outcome measure was the proportion of eyes achieving visual acuity (Va) 20/40 or better, while secondary outcome measures included mean visual acuity and proportion of eyes developing a complication. The study was approved by our Institution’s Review Board.

Results:: Ten of 22 eyes (6 patients) were left aphakic (Group A) while 12 of 22 eyes (6 patients) received an iris-sutured intraocular lens (Group L). Mean age at surgery (group A: 7.5 years, group L: 5.5 years, p=0.35), mean follow-up (group A: 21.9 months, group L: 19.8 months, p=0.82) and preoperative best corrected logMAR visual acuity (group A: 0.83 (20/134), group L: 0.80 (20/117), p=0.81) were similar in the two groups. There was no statistically significant difference between the two groups in the proportion of eyes achieving visual acuity of 20/40 or better (Group A: 5/10, Group L: 10/12, p=0.17) or in the mean postoperative best-corrected logMAR visual acuity (Group A: 0.41 (20/52), Group L: 0.24 (20/35), p= 0.18). Complications included intraocular lens dislocation in 4/12 eyes from Group L (33%, 95% confidence interval: 11-65%). Eyes with dislocated lenses underwent retrieval with refixation of the intraocular lens and resulted in a mean Va 20/28. No retinal detachment has been observed to date.

Conclusions:: In the intermediate term, pars plana lensectomy-vitrectomy appears to be a safe option for the management of ectopia lentis. Insertion of an iris-fixated intraocular lens was not associated with better visual outcomes and carries a significant risk of dislocation. Patients with bilateral ectopia lentis are therefore best left aphakic.

Keywords: vitreous • amblyopia • visual development: infancy and childhood 
© 2007, The Association for Research in Vision and Ophthalmology, Inc., all rights reserved. Permission to republish any abstract or part of an abstract in any form must be obtained in writing from the ARVO Office prior to publication.
Copyright © 2025 Association for Research in Vision and Ophthalmology.
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