{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T05:42:46Z","timestamp":1791438166452,"version":"4.3.3"},"reference-count":16,"publisher":"Georg Thieme Verlag KG","issue":"10","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Klin Monbl Augenheilkd"],"published-print":{"date-parts":[[2021,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>\n          Background Subluxation of the crystalline lens in childhood confronts the surgeon with a dilemma: to operate or to wait and see. Surgery is usually not performed when the subluxation is still limited. However, postponing the surgery increases the surgical difficulty as the capsular bag becomes more difficult to use as a means of support for the intraocular lens (IOL). A large number of children already present a pronounced subluxation at first presentation. In this paper, we describe a technique to optimise centration and fixation of the bag-in-the-lens (BIL) IOL in children younger than 7 years of age with congenital ectopia lentis.<\/jats:p><jats:p>\n          Methods Between October 2019 and December 2020, we performed lens extraction using a combination of bean-shaped segments to support the BIL IOL and a 6\u200a\u2013\u200a0 polypropylene loop fixated at the sclera, following the Yamane technique, for the purpose of centration. We used this technique for seven eyes of four patients. The patients were between 2 and 6 years old; 3 boys and 1 girl. A definite diagnosis of Marfan syndrome was made for two children; for the other two, there was no proven underlying pathology. The luxation was upwards in all cases. The degree of luxation was severe in all eyes. The preoperative refraction values showed high astigmatism values for all eyes, ranging from 6.5 to 11.25 dioptres. Three out of the four patients were myopic, ranging from \u2212\u20091.5 to \u2212\u20099 dioptres.<\/jats:p><jats:p>\n          Results The surgery could be performed without major complications in all eyes. Good centration was obtained, which remained stable in the postoperative period. Refraction improved with greatly diminished degrees of astigmatism (ranging from 0.25 to 3 dioptres) and myopia (spheres ranging from \u2212\u20092 to +\u20091.75 dioptres).<\/jats:p><jats:p>\n          Conclusion Our novel technique incorporated the BIL technique with the addition of bean-shaped segments and a polypropylene 6\/0 suture fixated at the sclera. In this way, we were able to obtain good centration and stability of the implanted IOL, as well as a good refractive outcome in all cases.<\/jats:p>","DOI":"10.1055\/a-1633-4316","type":"journal-article","created":{"date-parts":[[2021,10,18]],"date-time":"2021-10-18T23:30:53Z","timestamp":1634599853000},"page":"1058-1064","source":"Crossref","is-referenced-by-count":7,"title":["Adapted Bag-in-the-Lens Implantation Technique in Children with Congenital Ectopia Lentis"],"prefix":"10.1055","volume":"238","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7879-4232","authenticated-orcid":false,"given":"Luc","family":"Van Os","sequence":"additional","affiliation":[{"name":"Ophthalmology, University Hospital Antwerp, Edegem, Belgium"},{"name":"Ophthalmology, Visual Optics and Visual Rehabilitation, University of Antwerp, Antwerp, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"G\u00f6ran Darius","family":"Hildebrand","sequence":"additional","affiliation":[{"name":"Paediatric ophthalmology, Oxford Eye Hospital, Oxford, United Kingdom of Great Britain and Northern Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marie-Jos\u00e9","family":"Tassignon","sequence":"additional","affiliation":[{"name":"Ophthalmology, University Hospital Antwerp, Edegem, Belgium"},{"name":"Ophthalmology, Visual Optics and Visual Rehabilitation, University of Antwerp, Antwerp, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2021,10,18]]},"reference":[{"key":"ref1","doi-asserted-by":"crossref","first-page":"1136","DOI":"10.1016\/j.ophtha.2017.03.036","article-title":"Flanged Intrascleral Intraocular Lens Fixation with Double-Needle Technique","volume":"124","author":"S Yamane","year":"2017","journal-title":"Ophthalmology"},{"key":"ref2","doi-asserted-by":"crossref","first-page":"1387","DOI":"10.1097\/j.jcrs.0000000000000260","article-title":"Adjustable 6-0 polypropylene flanged technique for scleral fixation, part 1: primary fixation IOLs in aphakia, capsular stabilizing devices, and aniridia implants","volume":"46","author":"E I Assia","year":"2020","journal-title":"J Cataract Refract Surg"},{"key":"ref3","doi-asserted-by":"crossref","first-page":"257","DOI":"10.1097\/ICO.0000000000002185","article-title":"Four-Flanged Intrascleral Intraocular Lens Fixation Technique: No Flaps, No Knots, No Glue","volume":"39","author":"S Canabrava","year":"2020","journal-title":"Cornea"},{"key":"ref4","doi-asserted-by":"crossref","first-page":"19","DOI":"10.1097\/ICU.0000000000000720","article-title":"Flanged fixation: Yamane technique and its application","volume":"32","author":"S Yamane","year":"2021","journal-title":"Curr Opin Ophthalmol"},{"key":"ref5","doi-asserted-by":"crossref","first-page":"454","DOI":"10.3928\/1081597X-20170504-08","article-title":"Bean-shaped Ring Segments as a Capsule Enhancement Tool in Complex Bag-in-the-Lens Intraocular Lens Implantation","volume":"33","author":"A Altenburg","year":"2017","journal-title":"J Refract Surg"},{"key":"ref6","first-page":"153","volume-title":"Zonulolysis and Lens Luxation","author":"N E Boonstra","year":"2019"},{"key":"ref7","first-page":"167","volume-title":"Scleral Anchoring of the Modified Bean-Shaped Ring Segments","author":"A C Dogaroiu","year":"2019"},{"key":"ref8","first-page":"1436834","article-title":"Age Differences in Axial Length, Corneal Curvature, and Corneal Astigmatism in Marfan Syndrome with Ectopia Lentis","volume":"2","author":"J Chen","year":"2018","journal-title":"J Ophthalmol"},{"key":"ref9","doi-asserted-by":"crossref","first-page":"1138","DOI":"10.1111\/ceo.13596","article-title":"Visual outcome and surgical results in children with Marfan syndrome","volume":"47","author":"S Rezar-Dreindl","year":"2019","journal-title":"Clin Exp Ophthalmol"},{"key":"ref10","doi-asserted-by":"crossref","first-page":"178","DOI":"10.3928\/01913913-20130108-02","article-title":"Visual outcome and changes in corneal endothelial cell density following aphakic iris-fixated intraocular lens implantation in pediatric eyes with subluxated lenses","volume":"50","author":"S N Siddiqui","year":"2013","journal-title":"J Pediatr Ophthalmol Strabismus"},{"key":"ref11","doi-asserted-by":"crossref","first-page":"1531","DOI":"10.1007\/s10792-020-01322-7","article-title":"Outcome of sutured scleral fixated intraocular lens in Marfan syndrome in pediatric eyes","volume":"40","author":"P Sen","year":"2020","journal-title":"Int Ophthalmol"},{"key":"ref12","doi-asserted-by":"crossref","first-page":"1685","DOI":"10.1016\/j.jcrs.2014.12.057","article-title":"Pediatric bag-in-the-lens intraocular lens implantation: long-term follow-up","volume":"41","author":"J Van Looveren","year":"2015","journal-title":"J Cataract Refract Surg"},{"key":"ref13","doi-asserted-by":"crossref","first-page":"364","DOI":"10.1111\/aos.13626","article-title":"Phacoemulsification and primary implantation with bag-in-the lens intraocular lens in children with unilateral and bilateral cataract","volume":"96","author":"A Nystr\u00f6m","year":"2018","journal-title":"Acta Ophthalmol"},{"key":"ref14","doi-asserted-by":"crossref","first-page":"296","DOI":"10.1111\/aos.14244","article-title":"Secondary glaucoma and visual outcome after paediatric cataract surgery with primary bag-in-the-lens intraocular lens","volume":"98","author":"A Nystr\u00f6m","year":"2020","journal-title":"Acta Ophthalmol"},{"key":"ref15","doi-asserted-by":"crossref","first-page":"1372","DOI":"10.1016\/j.jcrs.2019.05.032","article-title":"Precision of bag-in-the-lens intraocular lens power calculation in different age groups of pediatric cataract patients: Report of the Giessen Pediatric Cataract Study Group","volume":"45","author":"L M Lytvynchuk","year":"2019","journal-title":"J Cataract Refract Surg"},{"key":"ref16","doi-asserted-by":"crossref","first-page":"e144","DOI":"10.1111\/aos.14229","article-title":"Analysis and management of intraoperative and early postoperative complications of bag-in-the-lens intraocular lens implantation in different age groups of paediatric cataract patients: report of the Giessen Paediatric Cataract Study Group","volume":"98","author":"L M Lytvynchuk","year":"2020","journal-title":"Acta Ophthalmol"}],"container-title":["Klinische Monatsbl\u00e4tter f\u00fcr Augenheilkunde"],"original-title":[],"language":"de","link":[{"URL":"http:\/\/www.thieme-connect.de\/products\/ejournals\/pdf\/10.1055\/a-1633-4316.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,10,18]],"date-time":"2021-10-18T23:31:19Z","timestamp":1634599879000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.thieme-connect.de\/DOI\/DOI?10.1055\/a-1633-4316"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,10]]},"references-count":16,"journal-issue":{"issue":"10","published-online":{"date-parts":[[2021,10,18]]},"published-print":{"date-parts":[[2021,10]]}},"URL":"https:\/\/doi.org\/10.1055\/a-1633-4316","archive":["Portico","CLOCKSS"],"relation":{},"ISSN":["0023-2165","1439-3999"],"issn-type":[{"value":"0023-2165","type":"print"},{"value":"1439-3999","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,10]]}}}