Intraoperative performance and postoperative outcomes of endocapsular ring implantation in pediatric eyes

• Published in: Journal of cataract and refractive surgery Vol. 34; no. 9; pp. 1499 - 1508
• Main Authors: Vasavada, Vaishali, MS, Vasavada, Viraj A., MS, Hoffman, Robert O., MD, Spencer, Terrence S., MD, Kumar, Rishi V., MD, Crandall, Alan S., MD
• Format: Journal Article
• Language: English
• Published: New York, NY Elsevier Inc 01-09-2008; Elsevier Science
• Subjects: Acrylic Resins; Adolescent; Biological and medical sciences; Cataract - etiology; Child; Child, Preschool; Ectopia Lentis - complications; Ectopia Lentis - surgery; Female; Humans; Intraoperative Complications; Lens Capsule, Crystalline - surgery; Lens Implantation, Intraocular; Lenses, Intraocular; Male; Medical sciences; Ophthalmology; Phacoemulsification; Postoperative Complications; Prostheses and Implants; Prosthesis Implantation; Retrospective Studies; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Surgery of the eye and orbit; Visual Acuity - physiology; Human; Performance evaluation; Postoperative; Prognosis; Implantation; Intraoperative; Eye; Treatment; Ring; Surgery; Intracapsular; Evolution; Ophthalmology; Performance; Child
• ISSN: 0886-3350; 1873-4502
• DOI: 10.1016/j.jcrs.2008.04.044

Purpose To study the intraoperative performance and postoperative outcomes of Cionni modified capsule tension ring (CTR) and intraocular lens (IOL) implantation in the capsular bag in pediatric eyes with ectopia lentis. Setting John A. Moran Eye Center, Salt Lake City, Utah, USA. Methods Thirty-five eyes (22 children) with ectopia lentis and visually significant cataract that had lens aspiration and in-the-bag implantation of single-piece AcrySof IOL and Cionni CTR were included. Single- and double-eyelet CTRs were used. The rings were sutured to the sclera using 9-0 or 10-0 polypropylene (Prolene) sutures. Preoperative and postoperative best corrected visual acuity (BCVA), intraoperative performance, IOL centration, and complications were studied. Results The mean patient age was 8.2 years ± 5.1 (SD) and the median follow-up, 28 months. A double-eyelet CTR was implanted in 12 eyes and a single-eyelet CTR, in 23 eyes. The mean BCVA at the final follow-up (0.37 ± 0.25 logMAR, 33 eyes) was significantly better than preoperatively (0.78 ± 0.42 logMAR, 28 eyes) ( P = .003). At the last examination, the BCVA was 20/40 or better in 16 eyes (45.7%). Three eyes (8.5%) required resuturing for IOL decentration. Nineteen eyes (54.3%) had a secondary procedure for posterior capsule opacification. Other complications included anterior capsule opacification (2.85%), cystoid macular edema (5.71%), chronic uveitis (5.71%), and vitreous prolapse (2.85%). Conclusion Implantation of the Cionni CTR and single-piece AcrySof IOL in the capsular bag in pediatric eyes with subluxated lenses was safe and effective and led to a stable IOL with few significant complications.