Clinical profile and surgical outcomes in children with posterior lenticonus

AIMS: The purpose of this study is to describe the clinical profile of children presenting with posterior lenticonus. We also report on visual outcomes following surgery in these patients. SUBJECTS AND METHODS: Medical records of patients with a diagnosis of posterior lenticonus between January 2000 and December 2016 were reviewed. Data collected included demographic details, preoperative, intraoperative details like type of intraocular lens (IOL) and surgery, and amblyopia therapy. Only the patients with a follow-up of at least 6 months from the time of presentation were included in the analysis. RESULTS: Forty-eight eyes with posterior lenticonus with at least 6 months of follow-up were studied. Twelve (25%) eyes had a preoperative posterior capsule (PC) dehiscence as seen on slit-lamp biomicroscopy or on ultrasonography. The mean presenting visual acuity in all eyes was 1.034 ± 0.56 logarithm of the minimum angle of resolution (logMAR) units. The mean final visual acuity in these patients was 0.57 ± 0.5 logMAR units. Postoperative visual acuity was found to have a borderline positive correlation with the presence of preoperative strabismus (P = 0.049). Younger age at presentation (P = 0.533) or the presence of preoperative PC dehiscence (P = 0.735) did not influence final visual acuity. CONCLUSION: Visual acuity improves following surgery with IOL implantation in children with posterior lenticonus and cataract. With the availability of foldable lenses and improved surgical techniques, it is possible to place the IOL in bag despite a preexisting posterior capsular dehiscence. Children with posterior lenticonus who present with strabismus are likely to have poorer visual outcomes.