title: Scleral-fixated capsular tension rings and segments for ectopia lentis in children.
abstract: OBJECTIVE
  To report the short-term outcomes and complications of implantation of scleral-fixated capsular tension rings and/or capsular tension segments with intraocular lenses (IOL) in pediatric patients with ectopia lentis.
  
  
  METHODS
  Retrospective, observational case series.
  
  
  METHODS
  Thirteen consecutive pediatric patients (19 eyes) underwent placement of in-the-bag IOL with either a Cionni modified capsular tension ring or a capsular tension segment in conjunction with a conventional capsular tension ring between January 1, 2009 and March 30, 2013 by 3 anterior segment surgeons at a single academic center. The scleral fixation suture was 9-0 polypropylene in 16 eyes and CV-8 Gore-Tex (expanded polytetrafluoroethylene) in 3 eyes. Outcome measures included change in corrected distance visual acuity (CDVA) and complications.
  
  
  RESULTS
  The mean age was 10.2 years ± 4.8 (SD) and the median follow-up, 23.4 months. A Cionni modified capsular tension ring was implanted in 5 eyes and a capsular tension segment with an unsutured capsular tension ring was implanted in 12 eyes. In 2 eyes, capsular tension segment alone was placed. The mean CDVA at the final follow-up (0.10 ± 0.11 logMAR, 18 eyes) was significantly better than preoperatively (0.58 ± 0.26 logMAR, 15 eyes) (P < .001). The CDVA at the final follow-up was 20/40 or better in 18 eyes (94.7%). All IOLs were well centered. Posterior capsule opacification developed in 11 eyes (57.9%), 9 eyes (47.4%) required neodymium-yttrium-aluminum-garnet capsulotomy, and 3 eyes (15.8%) required pars plana vitrectomy and posterior capsulotomy. Other complications included broken suture (5.3%) (9-0 polypropylene at CTR eyelet, repaired with CV-8 Gore-Tex), conjunctival dehiscence (5.3%), suture exposure (5.3%) (trans-scleral 9-0 polypropylene), and vitreous strand at inferior paracentesis (5.3%).
  
  
  CONCLUSIONS
  Implantation of in-the-bag IOL with either a Cionni modified capsular tension ring or a capsular tension segment in conjunction with a conventional capsular tension ring appears to be a safe and effective technique for visual rehabilitation in pediatric ectopia lentis.
authors.affiliation: Department of Ophthalmology, Texas Children's Hospital, Houston, Texas; Cullen Eye Institute, Department of Ophthalmology, Baylor College of Medicine, Houston, Texas.
authors.forename: Eric J
authors.initials: EJ
authors.lastname: Kim
authors.affiliation: Department of Ophthalmology, Texas Children's Hospital, Houston, Texas; Cullen Eye Institute, Department of Ophthalmology, Baylor College of Medicine, Houston, Texas.
authors.forename: James P
authors.initials: JP
authors.lastname: Berg
authors.affiliation: Cullen Eye Institute, Department of Ophthalmology, Baylor College of Medicine, Houston, Texas.
authors.forename: Mitchell P
authors.initials: MP
authors.lastname: Weikert
authors.affiliation: Department of Ophthalmology, Texas Children's Hospital, Houston, Texas; Cullen Eye Institute, Department of Ophthalmology, Baylor College of Medicine, Houston, Texas.
authors.forename: Lingkun
authors.initials: L
authors.lastname: Kong
authors.affiliation: Cullen Eye Institute, Department of Ophthalmology, Baylor College of Medicine, Houston, Texas.
authors.forename: Marshall B
authors.initials: MB
authors.lastname: Hamill
authors.affiliation: Cullen Eye Institute, Department of Ophthalmology, Baylor College of Medicine, Houston, Texas.
authors.forename: Douglas D
authors.initials: DD
authors.lastname: Koch
authors.affiliation: Department of Ophthalmology, Texas Children's Hospital, Houston, Texas; Cullen Eye Institute, Department of Ophthalmology, Baylor College of Medicine, Houston, Texas. Electronic address: kgyn@texaschildrenshospital.org.
authors.forename: Kimberly G
authors.initials: KG
authors.lastname: Yen
mesh_terms: D000293:Adolescent; D000869:Anterior Eye Segment / Q000601:surgery*; D002648:Child; D002675:Child, Preschool; D004479:Ectopia Lentis / Q000503:physiopathology / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007903:Lens Capsule, Crystalline / Q000601:surgery*; D007910:Lenses, Intraocular; D008297:Male; D018918:Phacoemulsification; D011474:Prosthesis Design; D012189:Retrospective Studies; D012590:Sclera / Q000601:surgery*; D013536:Suture Techniques; D013997:Time Factors; D016896:Treatment Outcome; D014792:Visual Acuity