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Management of ectopia lentis combining Cionni capsular tension ring and Precizon toric IOL

Poster Details

First Author: M.Calatayud SPAIN

Co Author(s):                        

Abstract Details

Purpose:

To investigate the efficacy of Precizon toric IOL for the correction of the refractive status in patients with congenital subluxated crystalline lens. Capsular Tension Ring (CTR) is mandatory if the zonular weakness area is superior to 3 contiguous clock hours. Precizon Toric IOL is described by the manufacturer as a prosthesis with better tolerance to missalignment than others. With the assumption of some kind of unpredictability of the final position of the lens due to instability of the lens bag, we choose to associate this kind of IOL with Cionni CTR in both eyes of a 21 y-o young patient.

Setting:

Instituto Oftalmol�Ã�³gico QuironSalud, Barcelona, Spain

Methods:

Preoperative BCVA was 20/60 in the right eye (175�Â�º -3.50 -10.00) and 20/30 in the left eye ( 20�Â�º -4.75 -8.75).IOL power was estimated using IOLmaster axial length and topographic keratometries (SIRIUS) at calculator.ophtec.com. Both surgeries were performed under retrobulbar anesthesia, marking the axis in the slitlamp outside the operating room. Cionni CTR was fixed to the sclera using 2-needle 11-0 prolene 3 mm from the limbus into a previously practiced scleral groove. Postoperative treatment regime included topical steroids and antibiotics with progressive decrease of the dose over 1 month.

Results:

Postoperative refraction was 145�Â�º -1.75 �.75(RE) and neutral (LE) with a BCVA of 20/20 in both eyes. UCVA was 20/30 and 20/20, and spherical equivalent remained into the limits of 0.50 D , enough to allow the patient to have a good quality of life without glasses. The patient only needed some close vision correction for reading at specific moments. One year later the refraction is stable

Conclusions:

Ectopia lentis is always a challenging situation for the anterior segment surgeon. Therapeutical options are endocapsular or pars plana lensectomy combined with iris-fixated IOL or a scleral fixated CTR with the IOL placed into the bag. The aim of toric IOLs is to achieve the best UCVA, but a subluxated crystalline lens adds a stress factor due to some uncertain effective lens position depending on the accuracy of the bag fixation. Further studys must be performed, but Precizon toric IOL in addition to CTR must be considered as an effective option for this kind of patients.

Financial Disclosure:

NONE

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