Efficacy and Safety of Polypropylene Scleral Suture Fixation of Intraocular Lens in Pediatric Nontraumatic Ectopia Lentis: A Real-World Study.

Abstract

To report the efficacy and safety of scleral-suture fixation of intraocular lens (SFIOL) in children with nontraumatic ectopia lentis (EL) in a real-world setting. Retrospective case series. The retrospective study included 220 eyes of 123 children with nontraumatic EL completing a minimum of 3 years of postoperative follow-up, and was conducted at the Zhongshan Ophthalmic Center, Sun Yat-sen University (Guangzhou, China). Lens extraction with primary SFIOL was performed in all eyes. The efficacy outcome was postoperative corrected distance visual acuity (CDVA). The safety outcomes were postoperative complications and the rate of additional surgery. The secondary outcomes were change in refraction and IOL centration. The mean age at surgery of the cohort was 7.62 ± 3.41 years, and the median follow-up duration was 4.04 (interquartile range [IQR] = 3.41-5.17) years. In all, 87.2% eyes had CDVA greater than or equal to 0.5 at final follow-up. The postoperative complications included suture exposure in 19 eyes (8.6%), IOL dislocation in 17 eyes (7.7%), IOL pupillary capture in 7 eyes (3.2%), persistent high intraocular pressure in 4 eyes (1.8%), retinal detachment in 3 eyes (1.3%), and endophthalmitis in 2 eyes (0.9%). The additional surgery rate was 7.7%, including retinal detachment in 3 eyes and IOL dislocation in 14 eyes. The postoperative refraction showed a tendency toward myopia. The mean IOL tilt and decentration were 8.6 ± 5.7° and 0.75 ± 0.38 mm, respectively. SFIOL is an effective method for managing children with nontraumatic EL, but with a certain incidence of complications. Suture exposure and IOL dislocation are the most common complications and may occur over time. Strengthening the postoperative long-term follow-up is crucial for children with nontraumatic EL.