Surgical Management of Microspherophakia in Young Patients and Associated Visual Outcomes: A Narrative Review

Microspherophakia (MSP) is a rare crystalline lens development abnormality characterised by increased anteroposterior thickness and decreased equatorial diameter. It is connected with a variety of ocular and systemic diseases, the most serious of which is secondary glaucoma. Early identification, proper lens and glaucoma care, and adequate visual rehabilitation can all help to avoid glaucoma-related blindness. Because MSP mostly affects young people, a multidisciplinary approach with ongoing follow-up is strongly advised. The rarity of this illness has hampered the availability of large-scale prospective investigations, with current information primarily obtained from case reports and retrospective analysis. This makes the development of standardised treatment guidelines problematic. The purpose of this review is to examine the surgical aspects of managing MSP in young patients and to evaluate the associated visual outcomes. To alleviate zonular weakness, surgical treatment options include techniques such as lens extraction with or without Intraocular Lens (IOL) implantation, as well as more sophisticated approaches such as scleral-fixated IOLs, iris-claw lenses, and capsular tension devices. Recent research suggests that prompt surgical intervention can greatly improve visual acuity and overall quality of life in afflicted patients. Nonetheless, long-term treatment must include possible problems such as glaucoma, zonular instability, as well as IOL displacement. This review emphasises the significance of individualised surgical methods, coordinated multidisciplinary therapy, and long-term follow-up in achieving excellent visual results in young people with MSP. It also emphasises the importance of bigger prospective studies and the creation of standardised surgical guidelines for improving evidence-based clinical practice.