Retrospective review of visual outcome in operated lens subluxation

Objectives: 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. Methods: 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. Results: 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). Conclusions: 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.