Iris-sutured intraocular lenses for ectopia lentis in children

Purpose: To compare outcomes and complications of pars plana lensectomy-vitrectomy (PPL-PPV) for the management of ectopia lentis in children with and without a foldable iris-sutured intraocular lens (IOL). Setting: Department of Ophthalmology, Baylor College of Medicine, Houston, Texas, USA. Methods: This study comprised 22 eyes of 12 consecutive pediatric patients with ectopia lentis who had PPL-PPV by the same vitreoretinal surgeon with (12 eyes; Group L) or without (10 eyes; Group A) insertion of a foldable iris-sutured IOL between June 1998 and October 2006. Outcome measures included the proportion of eyes achieving visual acuity of 20/40 or better, mean logMAR visual acuity, and complications. Results: There was no statistically significant difference between the 2 groups in the proportion of eyes achieving a visual acuity of 20/40 or better (Group A: 5/10; Group L: 10/12) (P = .17) or the mean postoperative best corrected logMAR visual acuity (Group A: 0.41 [20/52]; Group L: 0.24 [20/35]) (P = .18). Complications included IOL dislocation in 4 (33%) of 12 eyes in Group L (95% confidence interval, 11%-65%). Eyes with dislocated IOLs had retrieval with resuturing of the IOL to the iris and had a mean visual acuity of 20/27 at the last follow-up. No retinal detachment was observed. Conclusion: Pars plana lensectomy-vitrectomy with iris-fixation of a foldable IOL for the management of ectopia lentis yielded visual outcomes as least as good as those of optically corrected aphakia with a significant risk for dislocation.