About the Author(s)

Julie D. Barliana Email symbol
Department of Ophthalmology, Faculty of Medicine, Universitas Indonesia-Cipto Mangunkusumo National Central Hospital, Jakarta, Indonesia

Dian E. Yulia symbol
Department of Ophthalmology, Faculty of Medicine, Universitas Indonesia-Cipto Mangunkusumo National Central Hospital, Jakarta, Indonesia

Diajeng A. Soeharto symbol
Department of Ophthalmology, Faculty of Medicine, Universitas Indonesia-Cipto Mangunkusumo National Central Hospital, Jakarta, Indonesia


Barliana JD, Yulia DE, Soeharto DA. Management of paediatric ectopia lentis at an Indonesian referral hospital: A retrospective review. Afr Vision Eye Health. 2022;81(1), a768. https://doi.org/10.4102/aveh.v81i1.768

Original Research

Management of paediatric ectopia lentis at an Indonesian referral hospital: A retrospective review

Julie D. Barliana, Dian E. Yulia, Diajeng A. Soeharto

Received: 20 Apr. 2022; Accepted: 01 June 2022; Published: 27 July 2022

Copyright: © 2022. The Author(s). Licensee: AOSIS.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Background: Ectopia lentis in children is rare and often associated with systemic conditions. Left untreated, it can lead to visually debilitating complications. Although there are various techniques available, no current consensus for treatment of paediatric ectopia lentis exists.

Aim: To describe the management and visual outcomes of paediatric ectopia lentis in an academic referral hospital.

Setting: This study was conducted at Cipto Mangunkusumo National Central General Hospital, Jakarta, Indonesia.

Methods: A retrospective review was conducted on the medical records of all paediatric ectopia lentis patients treated at our hospital, from 2011 to 2020. Primary outcomes include uncorrected visual acuity (UCVA), best-corrected visual acuity (BCVA), treatment, surgical technique, selection of intraocular lens (IOL), and postoperative complications.

Results: This study included 66 eyes of 39 patients. Average age at initial presentation was 7.8 (2–17) years. Aetiology was mostly non-traumatic, whilst four were secondary to trauma. All eyes except one underwent surgery, and IOLs were inserted in 57.4% of the non-traumatic cohort, with iris-claw IOL as the most popular choice (85.7%). Uncorrected visual acuity and BCVA significantly improved in pseudophakic and aphakic groups (p < 0.05). Nearly 60% achieved a BCVA of 6/12 or greater, and the proportion was higher amongst pseudophakic group. Ten eyes had post-operative complications, with a median onset of 393 (1–1095) days after surgery.

Conclusion: With varied techniques used to manage paediatric ectopia lentis, the choice of technique was dependent on individual patient condition and surgeon preference. Whilst the proportion of eyes with BCVA of ≥ 6/12 was higher amongst the pseudophakic eyes than aphakic eyes, IOL implantation entails the risk of complications, whereas no complications occurred in those left aphakic. Therefore, no particular technique can be considered marginally superior to the other, and larger studies are needed.

Keywords: ectopia lentis; children; pseudophakia; IOL; ophthalmic surgery.


Ectopia lentis is a rare finding in children that pertains to a displaced crystalline lens because of weak zonules. Apart from trauma, ectopia lentis is often found in systemic disorders, such as Marfan’s syndrome, homocystinuria, or Weil–Marchesani syndrome.1 If untreated, complications can arise, including luxation to the anterior or posterior chamber, corneal endothelium damage, glaucoma, and retinal detachment.2,3

In treating paediatric ectopia lentis, surgery may not be needed if visual rehabilitation and maturation are achieved through a conservative approach.3,4,5 However, a previous study reported ametropic amblyopia in 50% of patients despite maximal conservative management.4 Indications for surgery include low best-corrected visual acuity (BCVA) or progressively severe subluxation.3,4,5 Surgical intervention involves rendering the eye aphakic by removing the crystalline lens. Following this, visual rehabilitation presents the next therapeutic challenge. Options include aphakic spectacles, contact lenses, or intraocular lens (IOL) implants. Aphakic spectacles are often difficult for children to tolerate because of visual disturbances, including aniseikonia, prismatic distortion, and constriction of visual fields, and the discomfort in wearing spectacles themselves. Contact lenses rely on compliance of wear and pose a higher risk of epithelial erosion than IOLs. Good visual outcome is dependent on compliance with amblyopia therapy in the first several years of life. With this, intolerance towards contact lenses or spectacles indicates IOL implantation.3,6,7

Intraocular lens used in children include angle-supported anterior chamber intraocular lens (ACIOL), iris-fixated IOL, posterior-chamber IOL (PCIOL) centred with a capsular tension ring (CTR), or scleral-fixated IOL (SFIOL). Each technique has its strengths and drawbacks. Anterior chamber intraocular lens is the most conventionally used IOL but is often related to endothelial cell loss, corneal decompensation, and pupillary ectopia. Because of these problems, posterior-chamber SFIOLs are generally preferred over ACIOLs in aphakic children with inadequate capsular support for PCIOL implantation. Another viable option for eyes lacking capsular support is iris-claw IOLs, which can be implanted anteriorly or retropupillary.4

This study aimed to describe the management and visual outcomes of children with ectopia lentis in an academic referral hospital in Indonesia.


Numerical data were described with mean (standard deviation [s.d.]), or median (minimum-maximum), depending on normality according to the Kolmogorov–Smirnov test. Categorical variables were presented in frequency and percentage, n (%). Visual acuity was presented in decimals based on Snellen chart. Further analysis of data on surgery separated subjects into the following sub-groups: traumatic and non-traumatic ectopia lentis, as well as pseudophakia (IOL implant) and aphakia. Measure of association was reported as the difference between means (p-value) and s.d. with 95% confidence interval (CI). Data were inserted into Microsoft Office Excel v 16.48 and analysed using IBM SPSS (Statistical Package for the Social Sciences) version 26.

Ethical considerations

A retrospective descriptive analysis was done on the medical records of all paediatric patients with ectopia lentis treated at Cipto Mangunkusumo National Central General Hospital, Jakarta, Indonesia, from January 2011 to December 2020. Patients were excluded if medical records were inaccessible. This study was granted ethical approval by the Health Research Ethics Committee-University of Indonesia/Cipto Mangunkusumo Hospital (Protocol Number: 21-05-0517) and in accordance with the Declaration of Helsinki. Extracted data include age, gender, aetiology, laterality, uncorrected visual acuity (UCVA), best-corrected visual acuity (BCVA), treatment, surgeon, surgical technique, and selection of IOL. Postoperative UCVA and BCVA were recorded at each patient’s last follow-up, and complications and onset were noted.


This retrospective study included 66 eyes of 39 patients: 29 were bilateral and 10 were unilateral (Table 1). Average age at initial presentation was 7.8 ± 3.5 years, ranging from two to 17 years. Aetiology was mostly unspecified, with 65% having unconfirmed or unidentified underlying systemic diseases. Nine patients had confirmed systemic diseases: eight patients with Marfan’s syndrome and one with homocystinuria as confirmed by the paediatrics department. Four patients were secondary to trauma. Average duration of follow-up was 16.5 ± 21.3 (0.5–96) months.

TABLE 1: Distribution of subject characteristics.

There were 62 eyes with non-traumatic ectopia lentis (Table 2). Only one eye did not undergo surgery as the patient tolerated conservative management with spectacles and achieved BCVA of 6/7.5. Overall average age at surgery was 7.9 ± 3.3 (3–17) years. Intraocular lenses were inserted in 35 eyes (57.4%) whilst 26 eyes (42.6%) were left aphakic. Average age at surgery was 8.3 ± 2.8 (5–14) years for pseudophakic eyes, and 7.3 ± 3.9 (3–17) years for eyes left aphakic. Amongst the 25 patients left aphakic, 24 eyes (96.2%) underwent intracapsular cataract extraction (ICCE) and anterior vitrectomy, whilst one eye underwent ICCE without anterior vitrectomy.

TABLE 2: Surgery on non-traumatic ectopia lentis (n = 61).

Amongst 35 pseudophakic patients, the majority had primary IOL insertion (27 eyes, 77.1%), where IOL implantation was done in the same procedure as ICCE and anterior vitrectomy. Seven eyes (20.0%) underwent secondary IOL insertion, where ICCE and anterior vitrectomy were conducted in the first surgery, followed by a separate procedure for secondary IOL implantation. One eye underwent irrigation aspiration and CTR with IOL implantation. Iris-claw IOL was the most popular IOL choice (30 eyes, 85.7%), followed by SFIOL (four eyes, 11.4%) and PCIOL (one eye, 2.9%).

There was a minority of traumatic ectopia lentis in this study, with four eyes of four patients (Table 3) and all eyes underwent surgery. Average age at surgery was 6.4 ± 2.7 years. Surgical technique was variable: one eye (25%) had secondary iris-claw IOL implant, two eyes (50%) had lensectomy with vitrectomy, and one of these eyes also underwent endolaser. Finally, one eye (25%) had three separate surgeries: irrigation-aspiration of coagulum and fibrin, followed by synechiolysis and cataract extraction, and lastly, the eye was fitted with a rigid gas permeable lens.

TABLE 3: Surgery in traumatic ectopia lentis (n = 4).

Visual acuity of the non-traumatic cohort was compared between baseline and after surgery (Table 4). Most eyes had improved uncorrected visual acuity (UCVA) after IOL implantation, with average postoperative UCVA (0.2 ± 0.2) higher than its baseline preoperatively (0.05 ± 0.05), and this was statistically significant (p < 0.05) in both aphakic and pseudophakic groups. However, three eyes that were left aphakic (4.8%) had UCVA that did not improve, where two eyes had unchanged UCVA, and one eye experienced a decrease in UCVA. Out of 61 eyes, comparison between UCVA could only be done in 34 eyes because of incomplete data.

TABLE 4: Ocular parameters in non-traumatic ectopia lentis.

Improvement between mean preoperative BCVA (0.3 ± 0.2) and mean postoperative BCVA (0.5 ± 0.3) was also found in the non-traumatic cohort, and this was also statistically significant (p < 0.05) in both aphakic and pseudophakic groups. Only one eye did not improve in BCVA, and this patient had pre-existing esotropia. Out of 61 eyes, comparison between BCVA could only be done in 26 eyes because of incomplete data.

Moreover, 32 (59.3%) of the eyes in this cohort achieved BCVA of 6/12 or greater, 23 eyes (71.9%) of which received IOL implant. The proportion of eyes with BCVA greater than or equal to 6/12 was higher amongst the pseudophakic group (23 eyes, 72.0%) than the aphakic group (nine eyes, 40.9%).

Comparison between preoperative and postoperative visual acuity was also done in the traumatic ectopic lens group. Average postoperative UCVA (0.008 ± 0.00) was not higher than its baseline preoperatively (0.01 ± 0.008). Average postoperative BCVA (0.2 ± 0.3) was slightly higher than its baseline preoperatively (0.13 ± 0.1). Of the three eyes that were analysed, one eye experienced an improvement in BCVA, whilst two eyes did not. Because of the limited sample size and missing data, proper statistical analysis could not be done.

From the 65 eyes in this study that underwent surgery, 10 eyes (15.4%) had postoperative complications, with a median onset of 393 (1–1095) days after surgery. Four eyes were that of patients with Marfan’s syndrome. Almost all complications occurred in the eyes with iris-claw IOL, except for one eye that had PCIOL. There were no post-operative complications in those who were left aphakic.

Intraocular lens de-enclavation occurred in four eyes (6.2%), with a median onset of 421 days (393–730 days). Two cases were immediately re-enclavated; another was managed by explanting the iris-claw IOL and switching to an SFIOL, whilst one case was left for observation. All resulted in good visual outcome.

Elevated intraocular pressure (IOP) occurred in three eyes (4.6%), with a median onset of 14 days (1–14 days). One case of elevated IOP one day after surgery was immediately treated with peripheral iridectomy. Another case was treated with glaucoma medication. Both cases had good visual outcomes. One case developed secondary glaucoma with severe inflammation two weeks after surgery and was treated with glaucoma medication, steroids, and antibiotics, and the eye recovered within a week.

Retinal detachment was reported in one eye three years after iris-claw implant and was treated with endolaser and silicone oil. Visual axis opacity was reported in one case 20 months following PCIOL implant and was treated with laser. Another eye was reported to have vitreous bleeding and corneal imbibition, which developed into phthisical eye in one week; treatment involved antibiotics and corticosteroid eyedrops. Endophthalmitis was found in one eye three weeks after surgery and was identified to have occurred because of external factors. This patient was treated with intravitreal antibiotics.


To date, no consensus has been established for the best management of ectopia lentis in children, as treatment plans are typically made on a case-by-case basis. In this study, nearly all eyes underwent surgery, except for one patient of the non-traumatic cohort. This patient was able to achieve good visual outcome through spectacle correction, and thus, conservative management without surgery was deemed adequate, which is in line with previous recommendations.3,4 In eyes that underwent surgery, nearly 60% had IOL implantation. Average age at first surgery amongst those left aphakic was slightly younger and consisted of a wider range than the IOL group (3–17 years vs 5–14 years). Intraocular lens implantation in younger children is less recommended because of immaturity and inflammation at infancy. Despite the study population consisting of relatively older children who were suitable for IOL implantation, the choice of technique was not determined solely by age; IOL implant was not required in children who tolerated and achieved acceptable BCVA with conservative correction.8,9 Amongst the pseudophakic eyes, nearly 78% underwent primary IOL implantation. Previous literature recommended primary IOL implantation if patients were at least 2–3 years of age, whilst those younger were recommended to be first left aphakic and corrected conservatively.5,10 Other considerations in delaying IOL implant include elevated risk of retinal detachment associated with Marfan’s syndrome, which may be exacerbated by lensectomy. Also, axial myopia is a common feature in Marfan’s, in which case leaving them aphakic might be preferable.11

Iris-claw IOL seems to be preferred in our referral centre because of its relatively simple technique and faster operation time whilst delivering equally good outcomes compared to other alternatives. However, iris-claw is associated with potential corneal endothelial cell decompensation, and there have been reports of de-enclavation occurring often.12,13,14,15,16 Unlike this study, SFIOLs are relatively more popular in current literature in the paediatric population, and its placement is considerably more physiological; however, complications, such as hyphema and vitreous haemorrhage, are common as scleral fixation requires direct involvement of vascular tissue, albeit such complications were not found in the one patient in this study who had SFIOL.4

This study demonstrated an overall good visual outcome, with a statistically significant improvement in UCVA and BCVA after surgery, with or without IOL implantation. Good visual outcomes in paediatric ectopia lentis patients who underwent surgery with or without IOL implantation have been shown in previous studies.13,15,16,17,18,19 In the non-traumatic cohort, 59.32% achieved BCVA of 6/12 or greater, the proportion of which was higher amongst pseudophakic eyes (72.0%) in comparison to aphakic eyes (40.9%). Contrastingly, previous studies have exemplified that 70.0% – 100.0% of aphakic patients from primary lensectomy achieved 6/18 or better, and as high as 93.0% achieved 6/12 or better.4,7,20 Previous studies stated that compliance towards visual rehabilitation is critical in optimal correction6; the less optimal visual outcome reported in this study may be explained by the lack of individual compliance towards spectacle use in the aphakic patients.

Comparable rates of pseudophakic eyes with good visual acuity were reported in previous studies, with 71% and 80% of the respective cohorts with retropupil iris-claw that achieved BCVA of 6/12 or greater.5,21 Studies on patients who received SFIOL reported slightly lower proportions, with 39.0%, 52.3%, and 61.6% who had BCVA greater or equal to 6/12.6,21,22 Epley et al. notably conducted a subgroup analysis in patients left aphakic after 9 years of age, thereby after the amblyopic age range, and revealed a much higher proportion of 83% that achieved BCVA of 6/12 or greater.6 Similarly, this study’s finding of a larger proportion of pseudophakic eyes that achieved at least 6/12 visual acuity may be attributed to the cohort of older children.

Ten eyes in this study experienced post-operative complications, with a median onset of 393 days. Almost all complications occurred in the eyes with iris-claw IOL, with the exception of one eye with PCIOL. This higher rate in the former group may be attributed to 87.5% of the pseudophakic patients being implanted with iris-claw IOL.

Intraocular lens de-enclavation occurred in four eyes with iris-claw IOL, with onset from surgery ranging from 393 to 730 days. Onset of iris-claw IOL de-enclavation after surgery varies widely between studies, ranging from one day to 84 months post-operatively.1,15,16,17,18,23 Whilst most of this study’s cases immediately underwent re-enclavation, one case had IOL explantation and exchange, and this process was similarly reported in Gonnermann et al., where they described a case of retropupil iris-claw IOL dislocation into the anterior chamber, which required explantation and IOL exchange.24 Intraocular lens detachment in SFIOL was also reported by Sen et al. in 6.8% of their cohort with an average onset of 8.15 (3–14) years.22

Elevated IOP occurred in three eyes, on average occurring after two weeks. This rate is comparable with the findings from previous studies, which reported three eyes after SFIOL implant.22 Two studies on anterior iris-claw each reported one case of glaucoma, which required peripheral iridectomy that occurred at three days and five months post-surgery, respectively.17,18 Similarly, studies on retropupil iris-claw reported one case that required trabeculectomy,21 one that was transient,25 and one that was controlled within a week with topical timolol and oral acetazolamide.23 Furthermore, one study stated that acute angle-closure glaucoma following anterior iris-claw IOL implantation occurred in 0.0% – 7.0% of patients, lower than that in secondary scleral-fixated PCIOL implantation (0.0% – 30.7%).26

Visual axis opacity was reported in one case 20 months following PCIOL implant using CTR. Surgeons generally avoid performing primary posterior capsulotomy and CTR in the same procedure because of its technical challenge. Therefore, one of the most common complications following paediatric cataract surgery with CTR is visual axis opacification which requires a second surgery.8 Another study mentioned posterior capsule opacification requiring intervention occurred in 83.8% of patients (31 out of 37) during the median follow-up of 27 months.4

Retinal detachment was reported in one eye three years after iris-claw implant. This patient was suspected of having Marfan’s syndrome, in which retinal detachment is a common finding. Fan et al.’s study reported 17.2% of their cohort of anterior iris-claw in adults and children with Marfan’s syndrome eyes experienced retinal detachment 1–48 months after surgery.10 Another study reported one case of retinal detachment secondary to severe blunt trauma to the eye.16 Retinal detachment is also found in cases of SFIOL, where it was observed to occur on average 17.3 months after surgery.22

Other complications found in the patients of this study include vitreous bleeding and corneal imbibition. Other studies on SFIOL reported five eyes with transient anterior uveitis less than 1 month after surgery,27 and another reported one eye with uveitis-glaucoma-hyphema syndrome.28 Sen et al. reported one eye after SFIOL implant with uncontrolled glaucoma that developed ciliary staphyloma and progressed to hypotonic maculopathy. This eye was treated with a scleral patch graft; however, this failed, and the eye became phthisical. The same study reported two eyes with vitreous haemorrhage and hyphema, and both were treated conservatively.22 Acute inflammation post-surgery, marked by anterior chamber cells, was seen in 60% of patients in both iris-claw and SFIOL groups in a study on adults, and reported one patient with uveitis after SFIOL implantation.29

In the present study, ectopia lentis secondary to trauma on average, did not experience much improvement in visual acuity after surgery. Albeit only one eye had an IOL inserted, and the issue of limited sample size prohibits proper statistical analysis. A study by Gawdat et al. which discussed seven post-traumatic patients reported that visual acuity increased and remained stable within a year of follow-up after anterior iris-claw implants.17

Limitations of this study include the wide variety of techniques used in the management of paediatric ectopia lentis. Because the number of patients that underwent each technique was not equal, proper statistical analysis between techniques could not be properly conducted. However, including all the different surgical techniques was considered necessary to accurately portray the many potential approaches one can use in the treatment of paediatric ectopia lentis. This referral centre’s choice of technique varied according to each surgeon’s preference. Another limitation is the missing data, as visual acuity could not be measured in uncooperative patients. Another limitation is that the aetiology in most patients was unspecified. Although underlying Marfan’s was often suspected in these patients, proper diagnosis could not be made in some of these patients. As a result, the researchers were unable to truly evaluate the risk entailed in patients with Marfan’s, such as the inherent risk towards retinal detachment and progressive refractive error.


In conclusion, this study reports the varied techniques used to manage paediatric ectopia lentis in an Indonesian national referral centre, where choice of technique was highly dependent on each patient’s condition and surgeon preference. Iris-claw IOL was the most common choice, and these patients had good visual outcome. Pseudophakic eyes had a higher proportion of eyes with BCVA greater than or equal to 6/12 in comparison to aphakic eyes. However, pseudophakic eyes entail risk of complications, whereas no complications occurred in those left aphakic. Therefore, not one technique can be considered as marginally superior to the other, and larger studies are needed.


Competing interests

The authors declare having no competing interests and no financial or personal relationships that may have inappropriately influenced the writing of this article.

Authors’ contributions

J.D.B. and D.E.Y. contributed to the initial concept and idea. J.D.B., D.E.Y., and D.A.S. contributed to the design, literature search, data acquisition, data analysis, statistical analysis, and all three authors discussed the results and contributed to manuscript preparation, editing, and manuscript review. J.D.B. and D.E.Y. supervised the entire process. J.D.B. served as guarantor.

Funding information

This research received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors.

Data availability

Data that support the findings of this study are available upon request from the corresponding author, J.D.B. The data are not publicly available at this time because of human data that can compromise the privacy of research participants.


Views expressed in this submitted article are that of the authors own and do not necessarily reflect the official position of the institution affiliated with the authors.


  1. Çevik SG, Çevik M, Özmen AT. Iris-claw intraocular lens implantation in children with ectopia lentis. Arq Bras Oftalmol. 2017;80(2):114–117. https://doi.org/10.5935/0004-2749.20170027
  2. Lifshitz T, Levy J, Klemperer I. Artisan aphakic intraocular lens in children with subluxated crystalline lenses. J Cataract Refract Surg. 2004;30(9):1977–1981. https://doi.org/10.1016/j.jcrs.2004.01.022
  3. Simon MA, Origlieri CA, Dinallo AM, Forbes BJ, Wagner RS, Guo S. New management strategies for ectopia lentis. J Pediatr Ophthalmol Strabismus. 2015;52(5):269–281. https://doi.org/10.3928/01913913-20150714-02
  4. Hsu HY, Edelstein SL, Lind JT. Surgical management of non-traumatic pediatric ectopia lentis: A case series and review of the literature. Saudi J Ophthalmol. 2012;26(3):315–321. https://doi.org/10.1016/j.sjopt.2012.05.001
  5. Rezar-Dreindl S, Stifter E, Neumayer T, Papp A, Gschliesser A, Schmidt-Erfurth U. Visual outcome and surgical results in children with Marfan syndrome. Clin Exp Ophthalmol. 2019;47(9):1138–1145. https://doi.org/10.1111/ceo.13596
  6. Epley KD, Shainberg MJ, Lueder GT, Tychsen L. Pediatric secondary lens implantation in the absence of capsular support. J AAPOS. 2001;5(5):301–306. https://doi.org/10.1067/mpa.2001.117567
  7. Wu-Chen WY, Letson RD, Summers CG. Functional and structural outcomes following lensectomy for ectopia lentis. J AAPOS. 2005;9(4):353–357. https://doi.org/10.1016/j.jaapos.2005.03.004
  8. Kemmanu V, Rathod P, Rao HL, Muthu S, Jayadev C. Management of cataracts and ectopia lentis in children: Practice patterns of pediatric ophthalmologists in India. Indian J Ophthalmol. 2017;65(9):818–825. https://doi.org/10.4103/ijo.IJO_896_16
  9. Self JE, Taylor R, Solebo AL, et al. Cataract management in children: A review of the literature and current practice across five large UK centres. Eye. 2020;34(12):2197–2218. https://doi.org/10.1038/s41433-020-1115-6
  10. Fan F, Luo Y, Liu X, Lu Y, Zheng T. Risk factors for postoperative complications in lensectomy-vitrectomy with or without intraocular lens placement in ectopia lentis associated with Marfan syndrome. Br J Ophthalmol. 2014;98(10):1338–1342. https://doi.org/10.1136/bjophthalmol-2013-304144
  11. Singh K. Commentary: Management of dislocated and subluxated intraocular lens. Indian J Ophthalmol. 2020;68(6):1150. https://doi.org/10.4103/ijo.IJO_2071_19
  12. Cleary C, Lanigan B, O’Keeffe M. Artisan iris-claw lenses for the correction of aphakia in children following lensectomy for ectopia lentis. Br J Ophthalmol. 2012;96(3):419–421. https://doi.org/10.1136/bjophthalmol-2011-300579
  13. Sminia ML, Odenthal MT, Prick LJ, Cobben JM, Mourits MP, Völker-Dieben HJ. Long-term follow-up after bilateral Artisan aphakia intraocular lens implantation in two children with Marfan syndrome. J AAPOS. 2012;16(1):92–94. https://doi.org/10.1016/j.jaapos.2011.10.014
  14. Miraldi Utz V, Coussa RG, Traboulsi EI. Surgical management of lens subluxation in Marfan syndrome. J AAPOS. 2014;18(2):140–146. https://doi.org/10.1016/j.jaapos.2013.12.007
  15. Barbara R, Rufai SR, Tan N, Self JE. Is an iris claw IOL a good option for correcting surgically induced aphakia in children? A review of the literature and illustrative case study. Eye. 2016;30(9):1155–1159. https://doi.org/10.1038/eye.2016.140
  16. Català-Mora J, Cuadras D, Díaz-Cascajosa J, Castany-Aregall M, Prat-Bartomeu J, García-Arumí J. Anterior iris-claw intraocular lens implantation for the management of nontraumatic ectopia lentis: Long-term outcomes in a paediatric cohort. Acta Ophthalmol. 2017;95(2):170–174. https://doi.org/10.1111/aos.13192
  17. Gawdat GI, Taher SG, Salama MM, Ali AA. Evaluation of Artisan aphakic intraocular lens in cases of pediatric aphakia with insufficient capsular support. J AAPOS. 2015;19(3):242–246. https://doi.org/10.1016/j.jaapos.2015.03.014
  18. Manning S, Lanigan B, O’Keefe M. Outcomes after lensectomy for children with Marfan syndrome. J AAPOS. 2016;20(3):247–251. https://doi.org/10.1016/j.jaapos.2016.02.006
  19. Lalramhluni R, Rath S, Shrivastav A, Singh PK, Mayor R, Singh S. Refractive and visual outcomes after scleral fixated intraocular lens implantation in children with ectopia lentis. Nepal J Ophthalmol. 2020;12(1):75–82. https://doi.org/10.3126/nepjoph.v12i1.22252
  20. Noorani S, Khan A, Rubab S, Choudhary K. Management of ectopia lentis in children. Pak J Ophthalmol. 2007;23(4):181–187.
  21. Shuaib AM, El Sayed Y, Kamal A, El Sanabary Z, Elhilali H. Transscleral sutureless intraocular lens versus retropupillary iris-claw lens fixation for paediatric aphakia without capsular support: A randomized study. Acta Ophthalmol. 2019;97(6):e850–e859. https://doi.org/10.1111/aos.14090
  22. Sen P, Attiku Y, Bhende P, Rishi E, Ratra D, Sreelakshmi K. Outcome of sutured scleral fixated intraocular lens in Marfan syndrome in pediatric eyes. Int Ophthalmol. 2020;40(6):1531–1538. https://doi.org/10.1007/s10792-020-01322-7
  23. Rastogi A, Goray A, Thacker P, Kamlesh, Babita. Assessment of the safety and efficacy of primary retropupillary fixation of iris-claw intraocular lenses in children with large lens subluxations. Int Ophthalmol. 2018;38(5):1985–1992. https://doi.org/10.1007/s10792-017-0688-y
  24. Gonnermann J, Torun N, Klamann MK, et al. Posterior iris-claw aphakic intraocular lens implantation in children. Am J Ophthalmol. 2013;156(2):382–386.e1. https://doi.org/10.1016/j.ajo.2013.03.002
  25. Brandner M, Thaler-Saliba S, Plainer S, Vidic B, El-Shabrawi Y, Ardjomand N. Retropupillary fixation of iris-claw intraocular lens for aphakic eyes in children. PLoS One. 2015;10(6):e0126614. https://doi.org/10.1371/journal.pone.0126614
  26. Güell JL, Verdaguer P, Elies D, et al. Secondary iris-claw anterior chamber lens implantation in patients with aphakia without capsular support. Br J Ophthalmol. 2014;98(5):658–663. https://doi.org/10.1136/bjophthalmol-2013-304035
  27. Rastogi A, Kumar P, Dhiman S, Mishra M, Anand K, Bhardwaj A. Evaluation of functional outcome and stability of sutureless scleral tunnel fixated IOLs in children with ectopia lentis. Int J Ophthalmol. 2020;13(1):66–70. https://doi.org/10.18240/ijo.2020.01.10
  28. Byrd JM, Young MP, Liu W, et al. Long-term outcomes for pediatric patients having transscleral fixation of the capsular bag with intraocular lens for ectopia lentis. J Cataract Refract Surg. 2018;44(5):603–609. https://doi.org/10.1016/j.jcrs.2018.02.016
  29. Kim KH, Kim WS. Comparison of clinical outcomes of iris fixation and scleral fixation as treatment for intraocular lens dislocation. Am J Ophthalmol. 2015;160(3):463–469.e1. https://doi.org/10.1016/j.ajo.2015.06.010

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