Pediatric Lens Subluxation and Post-Lensectomy Visual Acuity

Sunday, April 19, 2015: 3:06 PM
Room 1B (San Diego Convention Center)
Deborah K. VanderVeen, MD
Bharti Nihalani-Gangwani, MD

To present visual acuity outcomes after lensectomy, with or without IOL implantation, in a series of patients with early childhood lens subluxation.

Retrospective review of age at intervention, surgical technique, and mode of pre- and post-operative refractive correction in a series of consecutive patients operated for childhood lens subluxation .  Comparison of variables that may be associated with better visual acuity outcome was performed; primary outcome measure is best corrected visual acuity (BCVA).

Nine patients (18 eyes) with documented lens subluxation by age 5 years were operated between 2007-2014; 8/9 had Marfan syndrome.  Age at surgery ranged from 2 to 19 years (mean/median 8 years).  Follow up ranged from 6 months to 7 years.  All but one patient had final BCVA of 20/25 or better in at least one eye.  Prolonged inadequate correction of high refractive error in the early years was associated with persistent mild amblyopia (20/40 to 20/60) in 5 eyes of 4 patients.

Surgery for lens subluxation in childhood may be delayed if appropriate refraction can be tolerated in the early years; poor compliance with correction may require early surgery to obtain the best final BCVA result.