Influencing factors of effective lens position in patients with Marfan syndrome and ectopia lentis

• Published in: British journal of ophthalmology p. bjo-2023-325017
• Main Authors: Shen, Xin, Chen, Zexu, Jia, WanNan, Wang, Yalei, Chen, Tianhui, Sun, Yang, Jiang, Yongxiang
• Format: Journal Article
• Language: English
• Published: BMA House, Tavistock Square, London, WC1H 9JR BMJ Publishing Group Ltd 10.04.2024; BMJ Publishing Group LTD
• Subjects: Accuracy; Biometrics; Cornea; Intraocular lenses; Lens and cataract; Marfan syndrome; Optics and Refraction; Phakic Intraocular Lenses; Surgeons; Surgery; Visual acuity; United States > US; Phakic Intraocular Lenses; Optics and Refraction
• ISSN: 0007-1161; 1468-2079
• DOI: 10.1136/bjo-2023-325017

AimsThe aim of this study was to analyse the effective lens position (ELP) in patients with Marfan syndrome (MFS) and ectopia lentis (EL).MethodsPatients with MFS undergoing lens removal and primary intraocular lens (IOL) implantation were enrolled in the study. The back-calculated ELP was obtained with the vergence formula and compared with the theoretical ELPs. The back-calculated ELP and ELP error were evaluated among demographic and biometric parameters, including axial length (AL), corneal curvature radius (CCR) and white-to-white (WTW).ResultsA total of 292 eyes from 200 patients were included. The back-calculated ELP was lower in patients undergoing scleral-fixated IOL than those receiving in-the-bag IOL implantation (4.54 (IQR 3.65–5.20) mm vs 4.98 (IQR 4.56–5.67) mm, p<0.001). The theoretical ELP of the SRK/T formula exhibited the highest accuracy, with no difference from the back-calculated ELP in patients undergoing in-the-bag IOL implantation (5.11 (IQR 4.83–5.65) mm vs 4.98 (IQR 4.56–5.67) mm, p=0.209). The ELP errors demonstrated significant correlations with refraction prediction error (PE): a 1 mm ELP error led to PE of 2.42D (AL<22 mm), 1.47D (22 mm≤AL<26 mm) and 0.54D (AL≥26 mm). Multivariate analysis revealed significant correlations of ELP with AL (b=0.43, p<0.001), CCR (b=−0.85, p<0.001) and WTW (b=0.41, p=0.004).ConclusionThis study provides novel insights into the origin of PE in patients with MFS and EL and potentially refines existing formulas.