ESCRS - PO488 - Primary Scleral Fixation Of The Capsular Bag With In-The-Bag Lens Implantation Versus Retropupillary Iris‑Claw Lens Implantation In Ectopia Lentis: Visual Outcomes And Complications

Primary Scleral Fixation Of The Capsular Bag With In-The-Bag Lens Implantation Versus Retropupillary Iris‑Claw Lens Implantation In Ectopia Lentis: Visual Outcomes And Complications

Published 2024 - 42nd Congress of the ESCRS

Reference: PO488 | Type: Free paper | DOI: 10.82333/940d-t425

Authors: Meriem Ouederni* 1 , Yasmine Houmane 1 , Mohamed Amine Jemai 1 , Rym Maamouri 1 , Monia Cheour 1

1Habib Thameur University Hospital,Tunis,Tunisia

Purpose

To report the visual outcomes and complications of primary implantation in ectopia lentis using two techniques, namely scleral fixation of the capsular bag with in-the-bag intraocular lens (IOL) implantation and retropupillary iris‑claw IOL implantation,
and to compare both surgical techniques.

Setting

Ophthalmology department of Habib Thameur University Hospital in Tunis, Tunisia.

Methods

A prospective observational study was conducted between January 2020 and June 2023. Eyes operated on for ectopia lentis with primary implantation of an IOL in a scleral-fixated capsular bag using capsular tension devices (group 1) or a retropupillary iris-claw IOL (group 2) with a follow-up of at least six months were included. Best-corrected visual acuity (BCVA) at one, three, six months and at the last follow-up were recorded. The occurrence of postoperative complications was noted.

Results

Thirty-three eyes of 20 patients were included. Median age was 13 years [7;25]. The eyes were divided into 20 and 13 eyes in groups 1 and 2 respectively. A mean postoperative follow-up of 8.21 months ± 3.26 revealed a significant improvement in BCVA in both groups (p <10-3). Four eyes had an IOL decentration with no visual impairment. Posterior capsular opacification was the most frequent complication in group 1 (six eyes). One case of retinal detachment occurred in group 2. A significant positive correlation (r=0.480, p=0.006) was found between preoperative BCVA and last follow-up BCVA, irrespective of the surgical technique used. We found no significant differences regarding postoperative BCVA and complications between the two groups.

Conclusions

Ectopic lens extraction with primary implantation offers a significant improvement in visual acuity, with satisfactory IOL stability. We found no significant differences between the two techniques in terms of visual outcomes and complications. Larger-scale prospective studies with longer follow-ups will enable us to better compare these two techniques.