In-bag vs out-of-bag intraocular lens implantation for ectopia lentis: prospective comparative study.

PURPOSE: To explore the effects of the 2 surgical methods on the short-term and long-term visual outcome of patients with congenital ectopia lentis (CEL). SETTING: Eye & ENT Hospital of Fudan University, Shanghai, China. DESIGN: Prospective comparative study. METHODS: All patients were divided into 4 groups according to age and operation method: children underwent in-bag or out-of-bag surgery and adult underwent in-bag or out-of-bag surgery. They were followed up 1 month, 3 months, and every 6 months postoperatively. Their corrected distance visual acuity (CDVA), axial length (AL) growth, prediction error (PE), and other parameters were recorded, compared, and analyzed. RESULTS: There was no significant difference between CDVA and PE in the same age group compared by surgical methods. CDVA in adults was better than that in children, but greater myopic drift occurred in PE. In general, CDVA of the 4 groups all showed a trend of improvement with the addition of follow-up years, while PE increased gradually. The rate of AL growth was lower in patients undergoing in-bag surgery than in patients undergoing out-of-bag surgery. CONCLUSIONS: Both in-bag and out-of-bag surgeries are safe and effective for patients with CEL. CDVA and PE were not affected by the type of surgery and were only related to the patient's age. However, the growth rate of AL will slow down in in-bag surgery. No matter children or adults, half a year after surgery is the window period for recovery, and active amblyopia training has significant implication for the recovery of visual quality.