Results of surgical treatment of children with lens subluxation

AIM: To assess the effectiveness of the surgical treatment of patients with lens subluxation, who were under 18 years old.

MATERIAL AND METHODS: This study presented an analysis of the results of surgical treatment of eight patients with lens subluxation. The operations were performed in the Department of Ophthalmology of the State Healthcare Institution of Healthcare MCMC “Bonum,” carried out in 2020–2022. The inclusion criteria were as follows: age under 18 years, Marfan-like phenotype, stages 2–4 subluxation, absence of retinal changes and other eye pathologies, and surgical treatment performed in 2020–2022. The mean age at the detection of lens subluxation was 3.9±2.0 years, and the age during primary surgery was 5.4±1.9 years. All patients underwent phacoaspiration of the subluxated lens with anterior vitrectomy, simultaneous implantation, and sclerocorneal fixation of the intraocular lens by the same surgeon using the same equipment and consumables.

RESULTS: The ophthalmological status was mainly assessed, and a statistical difference (p <0.05) was found between pre- and postoperative indicators. Before surgery, the maximum corrected visual acuity was 0.15±0.12 (min 0.02; max 0.5); spherical equivalent, 6.8±4.7 (min -15; max +16); total astigmatism value, 3.25±1.15 (min, 1; max, 6.5); and corneal astigmatism, 2.4±0.9 (min, 1; max, 3.9). After the surgical treatment, the maximum corrected visual acuity was 0.53±0.31 (min, 0.05; max, 0.9); spherical equivalent, −0.6±1.71 D (min −3.5; max +3); total astigmatism, -1.63±0.75 D (min, -0.25; max, −2.75); corneal astigmatism, 2.4±0.7 D (min 1; max 3.5). All operations were performed without complications. The postoperative period in patients was regarded as unreactive.

CONCLUSION: The results show that sclerocorneal fixation allows for reliable and safe fixation of intraocular lenses without capsule support. A statistically significant increase in visual acuity was found after surgery; however, for optimal functional results in the postoperative period, refractive errors and pleoptic treatment must be controlled.