Primary Posterior Iris Claw Implantation In Children With Ectopia Lentis

To study the outcome  of posterior iris claw lens in children with ectopia lentis in a large series

Tertiary Care Hospital

Children with large subluxation of lens who underwent lensectomy with posterior iris claw lens were prospectively evaluated over a period of two years. They underwent detailed paediatric evaluation along with appropriate testing. Full ophthalmic examination and systemic examination was performed.

This  study included 64 eyes of 42 patients with ectopia lentis who underwent lensectomy with by iris claw lens implantation. Mean age at surgery was 11.17 ± 5.43 years.  In 53  eyes visual acuity improved by atleast two lines  after surgery (0.96±0.23 to 0.29±0.14 post operative(p<0.001). Ovalisation of pupil occurred in 9 eyes and pigment deposition on IOL in 7 eyes The underlying etiology was Marfan syndrome (n = 18), Weil–Marchesani syndrome (n = 1), homocystinuria (n = 2) and  isolated in the rest.  Complications observed were  disenclavation of  haptic in 5 eyes, vitreous haemorrhage in one eye, endophthalmitis in 2 eyes, and late intercalary staphyloma in a patient with Marfan's Syndrome. None of the patients had retinal detachment

Posterior Iris claw lens is a reasonable option in children with ectopia lentis as there is improvement in visual acuity  following surgery without a significant risk of serious vision threatening complications.