Retrospective review of visual outcome in operated lens subluxation

ABSTRACT

To describe the visual outcome of patients with lens subluxation [LS], including ectopia lentis [EL] due to genetic causes, who underwent surgical correction using standard selection criteria and surgical techniques in order to assess effectiveness of current LS therapy. This is a retrospective review of 17 sequential patients with LS who underwent lens aspiration between 2000 and 2012 through an anterior [limbal] or posterior [pars plana] approach at King Abdulaziz University Hospital, Riyadh, Saudi Arabia. Snellen visual acuity was converted to the logarithm of the Minimum Angle of Resolution [logMAR] equivalent for statistical analysis. All statistical comparisons were performed by t-test. This series consisted of 28 eyes with causes of LS including Marfan syndrome [12 eyes], familial EL [5 eyes], homocystinuria [4 eyes], sickle cell anemia [2 eyes], and trauma [6 eyes]. Mean visual acuity [VA] for the entire group increased from 20/200 before surgery to 20/70 after surgery [p >/= 0.01]. Post-operative VA was >/= 20/60 in all eyes that did not have complicating factors such as amblyopia, retinal detachment, and/or other ocular abnormalities. Visual outcome of limbal and pars plana approaches was statistically similar [p >/= 0.29]. Patients with genetic causes of EL had a significantly better visual outcome than other patients [p >/= 0.01]; out of these, patients with Marfan syndrome had a better visual outcome than other patients with genetic abnormalities [p >/= 0.02]. Accepted surgical criteria and techniques improved visual outcome in patients with LS. Patients with Marfan syndrome and others genetic abnormalities without ocular complications had best visual outcomes: