Outcomes of three surgical approaches for managing ectopia lentis in Marfan syndrome

• Published in: European journal of ophthalmology Vol. 32; no. 1; pp. 242 - 248
• Main Authors: Erdogan, Gurkan, Kandemir Besek, Nilay, Onal Gunay, Betul, Agca, Alper
• Format: Journal Article
• Language: English
• Published: London, England SAGE Publications 01-01-2022
• Subjects: Adolescent; Adult; Child; Child, Preschool; Ectopia Lentis - etiology; Ectopia Lentis - surgery; Humans; Lens Implantation, Intraocular; Lenses, Intraocular; Marfan Syndrome - complications; Marfan Syndrome - surgery; Postoperative Complications; Retrospective Studies; Sclera - surgery; Suture Techniques; Young Adult; clinical tests; pars plana lensectomy; lens/cataract; dislocated crystalline lens; Biometry/axial length; surgical instruments/special techniques; IOLs
• ISSN: 1120-6721; 1724-6016
• DOI: 10.1177/1120672121992950

Objective:
To investigate the clinical outcomes of three surgical approaches for ectopia lentis in Marfan syndrome (MS) patients who had undergone crystalline lens removal with posterior chamber intraocular lens (IOL) implantation techniques comprising the intrascleral fixation of IOL, sutured scleral fixation of IOL, and IOL implantation with the use of a Cionni capsular tension ring (CTR).
Methods:
This is a retrospective comparative study, including 35 eyes of 21 patients who underwent the intrascleral fixation of IOL (group 1), scleral IOL fixation with the Z-suture (group 2), and IOL implantation with the use of a Cionni CTR (group 3) following crystalline lens removal. The surgical indications were as follows: no improvement in visual function after eyeglasses or contact lens application due to excessive irregular astigmatism and advanced crystalline lens decentration in which the edge of the crystalline lens came up to the optical axis, or dislocation of the crystalline lens resulting in aphakia and secondary glaucoma due to lens dislocation. The surgical outcomes and complications due to surgery were compared between the groups.
Results:
The mean age of the patients in the study was 12.3 ± 8.7 years (5–32 years). There were 10 eyes in group 1, 13 eyes in group 2, and 12 eyes in group 3. Visual acuity improved significantly in each group after surgery. Ocular residual astigmatism did not differ significantly between the groups (p = 0.51).
Conclusion:
There were no significant differences between the three surgical approaches in the current study in terms of the postoperative results and complications.