Pediatric Lens Subluxation and Post-Lensectomy Visual Acuity
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.