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First Author: A.Hostovsky ISRAEL
Co Author(s): M. Kinori N. Burla D. Sachs
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Comparing visual outcome and complications of aphakic iris claw lens between children and adults suffering from non-traumatic dislocation of the lens
This study comprised 37 eyes of 26 patients with non-traumatic dislocation of the crystalline lens due to Marfan syndrome or familial dislocation of lens who had iris claw lens implantation in our institute between 1999 and 2012. All of the patients were operated by the same surgeon. Mean follow-up time was 20.5 months. 13 (50%) of the patients were in the pediatric group (under age 18 at the time of the operation) and 13 (50%) were adults (over 18). The mean age at surgery was 7.4 years old (from 3.5 years old to 17) in the pediatric group and 32.27 years old (19 to 56 years old) in the adults group. Outcome measures included the proportion of eyes achieving visual acuity of 20/40 or better, mean logMAR visual acuity, mean improvement in logMAR visual acuity and complications.
There was no statistically significant difference between the two groups in the proportion of eyes achieving a visual acuity of 20/40 or better (Adults 18/18, 100%, pediatric 18/19, 95%) (P = .323), the mean postoperative best corrected logMAR visual acuity (Adults: 0.15; Pediatric: 0.16) (P = .86) or the improvement in best corrected logMAR visual acuity after the surgery (Adults: 0.41; Pediatric: 0.47) (P = .55). Overall complications rates was higher in the pediatric group (5/19, 26%) than in the adult group (2/18, 11%) but this difference was not statistically significant (P=0.23). Complications included dislocation of one of the claws in 3 (15%) of 19 eyes (in 2 patients) in the pediatric group versus 1 (5%) in the adult group and 2 (10%) events of hypotonia due to leakage from the surgery wound in the pediatric group versus one (5%) event in the adult group. Both of the children with the dislocation were males in their young Adolescence with a documented trauma to the operated eye. No sight- threatening complication was documented in either of the groups and all of the complications were treated with one additional procedure with no need for further treatment.
Implantation of iris claw lens is a safe option for vision correction in non-traumatic dislocation of the lens in all age groups. There was no statistically significant difference between the groups in surgery results or in complication rates. No sight threatening complication was observed in either of the groups. We do recommend, especially in young adolescence, to use protective eyewear during outsides activities.