Bakht Samer Khan, Muhammad Daud Khan.
A Review of 100 cases of Ectopia Lentis - Presentation, management and visual prognosis.
Pak J Ophthalmol Nov ;18(1):3-9.

One hundred patients with Ectopia Lentis were examined at the Department of Ophthalmology, Postgraduate Medical Institute, Lady Reading Hospital and Hayatabad Medical Complex, Peshawar from April 1997 to March 1999. Out of these, 72 patients (72%) were male and 28 patients (28%) were female. Seventy patients (70%) had unilateral while 30 patients (30%) had bilateral ectopia lentis. Ectopia Lentis was acquired in (66%) cases and congenital in 34 (34%) cases. Fifty-eight (58%) of acquired ectopia lentis were of traumatic and 8 (8%) were of non-traumatic origin. The male to female ratio in traumatic cases was 1.6:1. The commonest cause of trauma was stone in 20 cases (34.5%), Iron piece in 6 cases (10.3%), wood piece in 5 cases (8.6%) and slap on the face in 4 cases (6.9%). There were 3 cases, (5.2%) each of bomb blast, sports ball injury and couching. In 14 cases (24.13%) the causative agent was not known. The non-traumatic Ectopia Lentis were due to hypermature cataract, endophthalmitis or long-standing uveitis. Congenital ectopia lentis was due to Marfan`s syndrome in 10 cases (29.4%), homocystinura in 6 cases (21.4%), simple ectopia lentis in 4 cases (11.8%), will Marcheasani`s syndrome in 3 cases (8.8%), aniridia in 2 cases (5.9%) and infantile glaucoma in 2 cases (5.9%). In 7 cases (12.1%) the cause was not identified. Topographically 75 eyes (53.6%) had subluxation while 65 eyes (46.4%) had dislocation of lens. In 49 eyes (37.7%) the lens was dislocated posteriorly and in 12 eyes (9.2%) anteriorly. In 95 eyes the lens was partially or totally opaque, and in 45 eyes the lens was clear. Vitreous haemorrhage was seen in 10 eyes (7.1%), retinal detachment in 4 eyes (2.9%), maculopathy in 4 eyes (2.9%) and bullous keratopathy in 4 eyes (2.9%). Eight cases (8%) required correction of refractive error with no other treatment, while 76 cases (76%) required medical or surgical intervention. 14 eyes (10%) required trabeculectomy for uncontrolled glaucoma. ICCE was carried out in 36 eyes (25.7%), while ECCE was possible in 33 eyes (23.6%). Intra ocular lens was inserted in 8 eyes (5.7%). 37 eyes (26.4%) required vitrectomy while 2 eyes (1.4%) required retinal reattachment surgery. The visual out come was 6112 or better In 19 eyes (13.6 %), 6/18 to 6/60 in 55 eyes (39.3%), upto 3160 in 47 eyes (33.6%), less then 3/60 in 5 cases (3.6%) while in 19 eyes (13.6%) it was and they therefore only received symptomatic treatment.

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