Outcomes of Posterior Chamber IOL Fixation in Ectopia Lentis

Sunday, April 27, 2014: 3:26 PM
Room 151A (Boston Convention and Exhibition Center)
Joann J. Kang, MD, New York Eye & Ear Infirmary, New York, NY, USA
David C. Ritterband, MD, New York Eye and Ear Infirmary, New York, New York, USA
Alice Hong, MD, New York Eye and Ear, New York, New York, USA
Elaine I. Wu, MD, New York Eye and Ear Infirmary, New York, New York, USA
Richard S. Koplin, MD, New York Eye and Ear Infirmary, New York, NY, USA
John A. Seedor, MD, New York Eye and Ear Infirmary, New York, New York, USA

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.