July 2018
Volume 59, Issue 9
Open Access
ARVO Annual Meeting Abstract  |   July 2018
Long-term Outcomes for Pediatric Patients Undergoing Trans-Scleral Fixation of the Capsular Bag with Intraocular Lens for Ectopia Lentis
Author Affiliations & Notes
  • Leah Owen
    Ophthalmology, University of Utah Moran Eye Center, Salt Lake City, Utah, United States
  • Julia Byrd
    Ophthalmology, University of Utah Moran Eye Center, Salt Lake City, Utah, United States
    Ophthalmology, Children's National, District of Columbia, District of Columbia, United States
  • Marielle Young
    Ophthalmology, University of Utah Moran Eye Center, Salt Lake City, Utah, United States
  • Wei Liu
    Division of Epidemiology, University of Utah, Salt Lake City, Utah, United States
  • David Tate
    A.T. Still University School of Osteopathic Medicine in Arizona, Mesa, Arizona, United States
  • Yue Zhang
    Division of Epidemiology, University of Utah, Salt Lake City, Utah, United States
  • Alan S Crandall
    Ophthalmology, University of Utah Moran Eye Center, Salt Lake City, Utah, United States
  • Footnotes
    Commercial Relationships   Leah Owen, None; Julia Byrd, None; Marielle Young, None; Wei Liu, None; David Tate, None; Yue Zhang, None; Alan Crandall, None
  • Footnotes
    Support  RPB Unrestricted Grant to the John Moran Eye Center, University of Utah BIRCWH K12; PI Leah Owen, Primary Children's Foundation Early Career Award; PI Leah Owen
Investigative Ophthalmology & Visual Science July 2018, Vol.59, 442. doi:
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      Leah Owen, Julia Byrd, Marielle Young, Wei Liu, David Tate, Yue Zhang, Alan S Crandall; Long-term Outcomes for Pediatric Patients Undergoing Trans-Scleral Fixation of the Capsular Bag with Intraocular Lens for Ectopia Lentis. Invest. Ophthalmol. Vis. Sci. 2018;59(9):442.

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

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Abstract

Purpose : There is no consensus regarding surgical management of ectopia lentis in children. Trans-scleral fixation techniques are controversial and long-term outcomes unclear. We report a retrospective observational case series demonstrating long term outcomes of trans-scleral fixation of a capsular tension device with IOL placement in pediatric patients with ectopia lentis.

Methods : Pediatric patients were identified who had undergone lens extraction at the John Moran Eye Center between 1/2006 and 1/2016. Patients between the ages of birth to 18 years with atraumatic ectopia lentis who underwent trans-scleral fixation with a capsular tension device and implantation of an intraocular lens (IOL) were analyzed.

Results : We identified 37 patients, 67 eyes, who underwent trans-scleral fixation of the capsular bag with use of a capsular tension device fixated with 9-0 or 10-0 polypropylene, 8-0 Gore-Tex, or 9-0 nylon from 2006-2016. The mean age at time of surgery was 7.25 years (2-18 years) and mean follow-up was 35.3 months (0.25-120 months). The proportion of eyes demonstrating improvement in best-corrected visual acuity post-operatively was 78.5%, which demonstrated significance with a 95% confidence interval. In the immediate post-operative period one eye developed a hyphema and one eye underwent IOL repositioning at post-op month (POM) 3. Long-term complications included posterior capsule opacity in 35 eyes (52%) and uveitis-glaucoma-hyphema syndrome in 1 eye (1.5%); no other patients developed glaucoma. Three eyes (4.4 %) required IOL repositioning for spontaneous delayed IOL dislocation, 2 sutured with 8-0 Gore-Tex at POM8 and POY3 and 1 sutured with 9-0 polypropylene at POY7.

Conclusions : Trans-scleral fixation of the capsular bag using a capsular tension device offers improved vision and IOL stability in pediatric patients with ectopia lentis.

This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.

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