Outcomes of Posterior Chamber IOL Fixation in Ectopia Lentis
Narrative Responses:
Purpose
To evaluate the visual outcomes and complications of iris and scleral fixated intraocular lens (IOL) implantation in patients with non-traumatic ectopia lentis.
Methods
A retrospective chart review was conducted of 12 eyes of 8 patients with non-traumatic ectopia lentis who underwent combined pars plana vitrectomy, lensectomy and iris (11 eyes) or scleral (1 eye) IOL fixation at a single practice at The New York Eye and Ear Infirmary. Outcome measures include best-corrected visual acuity (BCVA), final refraction, and intraoperative and postoperative complications.
Results
Mean patient age was 29.2 years (range 14-59 years) and average time of follow up was 27.9 months. BCVA was ≥ 20/30 in 10 eyes and 1 eye had limited vision due to pre-existing retinal pathology. Mean postoperative refraction was -1.2 D myopia in 6 eyes, +1.1D hyperopia in 4 eyes, and plano in 2 eyes. Intraoperative complications include vitreous hemorrhage in 1 eye. IOL subluxation occurred in 5 eyes (3 patients) with a mean time of dislocation of 12.2 months. Four eyes underwent IOL repositioning with mean visual acuity of 20/25 at last follow up.
Conclusion
Posterior chamber IOL fixation may have good visual outcomes in patients with ectopia lentis. However, the high rate of IOL subluxation is a concern and further studies are needed to evaluate the long-term stability of posterior chamber IOL fixation in ectopia lentis.