Table 3.
Review of the literature
| Fan et al.[9] | Khokhar et al.[10] | Manning et al.[11] | Hsu et al.[5] | Catala-Mora et al.[12] | Current | |
|---|---|---|---|---|---|---|
| N (eyes) | 64 | 32 | 30 | 13 | 21 | 78 |
| M: F | 28/11 | 10/6 | 11/4 | 3/4 | 5/7 | 47/10 |
| Mean age (years) | 16.5 | 9.37 | 4.6 | 5.8 | 8 | 14.73 |
| Follow-up (months) | 36 | 3 | 13.8 yrs | 23.8 | 39.3 | 8.1±10.7 |
| Etiology | Marfan’s Syndrome 100% | Marfans-56.2% | Marfan’s syndrome- 100% | Familial ectopia lentis- 42.8% | Marfan syndrome - 58.3% | Marfan syndrome- 22.8% |
| Marfanoid habitus- 25% | Marfan syndrome- 42.8% | Idiopathic- 25% | Marfanoid habitus- 22.8% | |||
| Microspherophakia-18.7% | Idiopathic- 14.2% | Megalophthalmos-glaucoma-8.3% | WAGR syndrome- 1.7% | |||
| Ectopia lentis et pupillae- 8.3% | Homocystinuria- 1.7% | |||||
| Idiopathic - 51% | ||||||
| Mean extent of subluxation | Moderate- 65.6% | 7.11±1.44 clock hours | ||||
| Severe- 34.4% | ||||||
| Intervention | Lensectomy-vitrectomy, limbal 79.6%; pars-plana 20.4%, | Endocapsular lens aspiration | Pars-plana lensectomy | Limbal approach lensectomy vitrectomy and SFIOL (sutured) | 23 gauge PPV lensectomy artisan IOL | ILLA- 79.5% |
| lens aspiration- 14.1% | ||||||
| Phaco-aspiration- 2.6% | ||||||
| ICCE- 2.6% | ||||||
| PPL-1.3% | ||||||
| IOL implantation | 64.1% (SFIOL- 42.2%; ACIOL-28.1%) | 68.7% (all ACIOL) | 53.3% (Artisan aphakic iris fixated IOL) | 100% (SFIOL) | 85.7% (Artisan aphakic iris fixated IOL) | 46.2% (ACIOL-6, SFIOL- 21, PCIOL-9) |
| ECD loss | - | 7.1% | 15.4% | - | 5% | - |
| Corneal de-compensation | Nil | Nil | Nil | Nil | None | |
| Post-segment complications | RD - 17.2% | Nil | Nil | Nil | Mild VH- 28.5% | VH- 3.8% |
| RD- 4.7% | Endophthalmitis- 1.3% | |||||
| CME- 4.7% | ||||||
| Mean BCVA before surgery (LogMAR) | 0.5 | 0.6 | 0.66 | 0.86 | 0.91 | 0.85 |
| Mean BCVA after surgery (LogMAR) | 0.3 | 0.47 | 0.11 | 0.23 | 0.18 | 0.42 |
| AL (mm) | 26.2 | 25.3 | 24.29 | |||
| IOP rise | 3.1% | Nil | 3.3% | 7.7% | 10.3% | |
| Complications | IOL dislocation- 4.7% | IOL dislocation- 3.3% | Corectopia -38% (IOL incarceration- 2; vitreous in AC-1); optic capture - 31% | IOL dislocation with RD-1 | Vitreous in AC-5.1% | |
| Delefted IOL- 3.8% | ||||||
| Optic capture- 1.3% | ||||||
| VAO - 1.3% | ||||||
| Additional surgery/Procedure (n=eyes) | Nd-YAG capsulotomy- 1 | Nd-YAG capsulotomy- 1 | Vitrectomy with IOL refixation-1 case | Nd-YAG vitreolysis- 4 | ||
| IOL re-enclavation-1 | IOL explant with SFIOL-1 | |||||
| Secondary IOL -4 | IOL tapping with pupilloplasty-1, intravitreal antibiotic -1 | |||||
| Nd-YAG capsulotomy-1 | ||||||
| Comment | No difference in RD between aphakic and pseudo-phakic groups | No difference in CDVA between aphakic and pseudo-phakia groups | High incidence of amblyopia | No impact of age and extent of subluxation on post-operative CDVA. | ||
| Better visual outcome in the pseudo-phakia group. |
SFIOL- scleral fixated intra-ocular lens; PPV- pars-plana vitrectomy; IOL-intra-ocular lens; ILLA- intra-lenticular lens aspiration; ICCE- intra-capsular cataract extraction; PPL- pars-plana lensectomy; ACIOL- anterior chamber intra-ocular lens; PCIOL- posterior chamber intra-ocular lens; VA-visual acuity; RD- retinal detachment; VH- vitreous hemorrhage; CME- cystoid macular edema; AC- anterior chamber; VAO- visual axis opacification