Surgical management of great lens subluxation in young patients

Autores: 

B. Feijóo, M. Ferreira, J. Cabral, S. Teixeira, F. Esperancinha, I. Prieto

Resumo: 
     Purpose: To show our experience in the surgical management of great subluxations in young patients trying to preserve the capsular bag.
     Methods: In 13 eyes of patients, aged between 5 and 21 years, with great lens subluxation we tried to preserve the capsular bag. We used different types of capsular tension rings and segments, to achieve centration of the capsular bag and implant a foldable acrylic intraocular lens (IOL). In the younger patients, we performed primary posterior capsulotomy and anterior vitrectomy. When we failed to achieve centration, we used a posterior chamber foldable IOL with three-point scleral fixation to avoid tilt of the IOL or an anterior chamber iris claw IOL. A video presentation of the surgical techniques will be presented.
     Results: The anatomic and functional results were very good with a rapid recovery, despite the different surgical approaches performed. After surgery, no secondary glaucoma or retinal complications were recorded, with a minimal inflammatory reaction. Best-corrected visual acuity was improved in all cases.
     Conclusions: Different and efficient surgical procedures are described to manage the great subluxation of lens in young patients. The attempt of preserving the capsular bag is sometimes difficult and requires additional steps. Nevertheless, we believe that this surgical option is more physiologic and enables future interventions, if required.

 

Apresentado: 
no XXIV Congress of the European Society of Cataract and Refractive Surgeons, em Londres, Setembro de 2006