Surgical management in ectopia lentis, simplifying complexity
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First Author: L.Izquierdo Jr PERU
Co Author(s): L. Izquierdo Jr. C. Moctezuma P. Larco Jr. M. Henriquez
Describe our surgical technique in patients with Ectopia Lentis, as well as to evaluate its outcomes and complications.
Instituto de Ojos Oftalmosalud, Lima, Peru
27 eyes of 16 patients that underwent lensectomy and retropupillary Artisan IOL fixation due to lens subluxation were selected in this retrospective study from November 2018 to February 2020. All the patients were previously diagnosed with Marfan syndrome. Inclusion criteria were patients without previous ocular surgery or retinal detachment. In our technique, capsulorhexis is performed with radio frequency diathermy, and depending on the lens status, we continue with bimanual irrigation aspiration or phacoemulsification; then we proceed with anterior vitrectomy and capsular lysis; after inducing myosis an Artisan aphakia lens is implanted retropupillary in an inverse fashion.
The mean age at surgery was 14.7 ± 10.1 yo (range 4-37 yo) and mean post-operative follow-up period was 12.5 months (range 4-16 months). Mean Best-corrected visual acuity (BCVA) showed a significant improvement from 0.7±0.442 logMAR units at the baseline to 0.3±0.296 logMAR units postoperative. No IOL dislocation has been seen to date and only 2 patients came back to our service with a free haptic, which was promptly repaired, with no intraoperative or post operative complications.
We believe that this technique is of great aid to the surgeon operating patients with ectopia lentis from any cause. The use of radio frequency facilitates the capsulorhexis and lessens the complications. Artisan aphakia lens implantation confers a significant improvement in visual acuity and reduces the surgical time, and if needed, makes it easier to perform a lens exchange. We also realized that this technique is easier to teach -and learn- making it an invaluable tool for the ophthalmologists in formation.