Capsular tension ring and IOL implantation improve vision in children with ectopic lentis

CHICAGO — In-the-bag implantation of a modified capsular tension ring with a single-piece IOL not only improved visual results in a significant number of pediatric eyes with ectopia lentis, but also limited IOL dislocation and complications, a clinician said here.

Vaishali A. Vasavada, MS, presented results at the American Society of Cataract and Refractive Surgery meeting of a retrospective study that she and colleagues conducted. Their paper was named the best in the Pediatric Cataract, Refractive and Glaucoma session.

Dr. Vasavada and colleagues found that 88.5% of patients in the study had visual improvement after implantation of the capsular tension ring and IOL. While only 8.5% of eyes had IOL decentration or dislocation, about 60% had posterior capsule opacification, of which 19 eyes required a secondary procedure, she said.

"It is safe and effective to implant a Cionni ring and a single-piece IOL in the bag in pediatric eyes," Dr. Vasavada said.

She and colleagues reviewed results of 35 eyes of 22 patients with either traumatic or nontraumatic ectopia lentis at a mean age of 8.2 ± 5.1 years. Patients underwent cataract extraction with in-the-bag implantation of the AcrySof Single-Piece IOL (Alcon) and the Cionni single islet or double islet capsular tension ring (Morcher, FCI Ophthalmics). The median follow-up was 28 months.

Dr. Vasavada said that mean preoperative best corrected visual acuity was 0.78 ± 0.42 logMAR. Mean postoperative BCVA at final follow-up was 0.37 ± 0.25 logMAR, a significant improvement, she said. At the last follow-up, BCVA was greater than 20/40 in 16 eyes (45.7%).

Other complications found in the study included severe anterior capsule opacification (2.85% of patients), cystoid macular edema (5.71%), chronic uveitis (5.71%), posterior synechiae (5.71%) and vitreous prolapse (2.85%).