Peculiarities of surgical technique using a capsule ring for intra-capsular fixation of IOL in children with congenital subluxation of the lens

• Main Authors: L. A. Katargina, T. B. Kruglova, N. S. Egyian, N. N. Arestova
• Format: Article
• Language: Russian
• Published: Real Time Ltd 2019-06-01
• Series: Российский офтальмологический журнал
• Subjects: lens; ectopia; congenital; children; capsular ring; iol
• Online Access: https://roj.igb.ru/jour/article/view/270
• ISSN: 2072-0076; 2587-5760

The aim of the work is to develop a differentiated method of surgical treatment of children with congenital ectopia of the lens using a capsule ring and intra — capsule fixation of IOL.Material and methods. 15 children (28 eyes) at the age of 5–8 years with congenital ectopic lens I–III degree with the syndrome of Marfan, Weil — Marchesani, homocystinuria and isolated pathology were operated. The lens was removed after the introduction of the capsular ring by the method of phakoaspiration and aspiration — irrigation using viscoelastics. One-pieces models of the Acrysof IOL SN60AT and Hoya iSert model 251 were implanted. Anterior capsulorhexis was performed manually (сystotomy, needle, collet tools) and/or using an YAG laser. After hydrodissection of the lens masses, the ring was injected in the capsular bag using the injector, and then removed the lens masses and implanted a one-piece IOL.Results. The technique of performing individual stages was determined by the lens ectopia degree. At I–II degree of ectopia, manual or YAG-laser circular anterior capsulorhexis was performed. Limited anterior vitrectomy was performed in the zone of lens displacement at the III degree of ectopia and the presence of vitreous body. Visual acuity before surgery was from 0.04 to 0.1–0.15, after surgery — 0.1–0.15 — 0.6.Conclusion. The use of differentiated methods of different stages of surgery and the intra — capsule ring in congenital ectopia of the lens allows intra-capsular IOL implantation with high functional and anatomical results at a low level of intra-and postoperative complications.