Post-lensectomy Refractive Status and Visual Outcomes in Children with Non-Traumatic Ectopia Lentis: A Prospective Longitudinal Study

Abstract

Background: Ectopia lentis in children leads to significant refractive errors and visual impairment, often requiring surgical intervention. However, there is limited research in Pakistan on the surgical interventions and visual outcomes of pediatric patients with ectopia lentis. Furthermore, limited data exist regarding postoperative refractive status and visual outcomes following lensectomy in such cases.

Objective: To evaluate refractive outcomes, visual acuity, and intraocular pressure changes following in-the-bag lensectomy in children with non-traumatic ectopia lentis.

Methods: This prospective longitudinal observational study was conducted at Al-Shifa Trust Eye Hospital, Rawalpindi from 15 March to 15 September 2025. A total of 44 eyes of children aged 3–15 years undergoing lensectomy were included. Visual acuity, intraocular pressure, and spherical equivalent were assessed preoperatively and at 3 and 6 months postoperatively. Data were analyzed using repeated-measures ANOVA with Greenhouse–Geisser correction and Dunnett's post hoc test.

Results Visual acuity improved significantly, with poor vision decreasing from 52.3% preoperatively to 22.7% at 6 months, while good visual acuity increased from 29.6% to 40.9%. Mean IOP decreased from 16.57±1.50 to 14.82±1.40 mmHg (p =0.001). Mean SE shifted from −1.38±13.56 D to +12.18±3.41 D (p <0.001), stabilizing after 3 months. Systemic associations were present in 36.4% of patients, with Marfan syndrome being the most common.

Conclusion: In-the-bag lensectomy is a safe procedure for non-traumatic ectopia lentis in children, resulting in significant visual improvement, stable refractive outcomes, reduced IOP, and effective postoperative rehabilitation with aphakic spectacles.