Predicting axial length in patients with Marfan syndrome and ectopia lentis after modified capsular tension ring and intraocular lens implantation

• Published in: Journal of cataract and refractive surgery Vol. 49; no. 6; pp. 571 - 577
• Main Authors: Chen, Ze-Xu, Jia, Wan-Nan, Ma, Yong, Chen, Tian-Hui, Hong, Jia-Hao, Sun, Yang, Liu, Yan, Song, Ling-Hao, Jiang, Yong-Xiang
• Format: Journal Article
• Language: English
• Published: United States 01.06.2023
• Subjects: Adolescent; Child; Child, Preschool; China; Ectopia Lentis - complications; Ectopia Lentis - diagnosis; Ectopia Lentis - surgery; Humans; Lens Implantation, Intraocular; Lenses, Intraocular; Marfan Syndrome - complications; Marfan Syndrome - surgery; Retrospective Studies; Visual Acuity; China
• ISSN: 0886-3350; 1873-4502
• DOI: 10.1097/j.jcrs.0000000000001155

To predict the growth of axial length (AL) in patients with Marfan syndrome (MFS) and ectopia lentis (EL). Eye and ENT Hospital of Fudan University, Shanghai, China. Consecutive retrospective case series. Eyes were evaluated that had modified capsular tension ring and intraocular lens (IOL) implantation. The rate of AL growth (RALG) was calculated using AL divided by log10-transformed age. A multivariate linear regression model of RALG was developed after validation. 128 patients with MFS and EL were enrolled with a median follow-up duration of about 3 years. RALG was independent of age between 3 years and 15 years old ( P = .799) and decreased to 0 thereafter ( P = .878). Preoperative AL was associated with RALG in patients under 15 years old ( P = .003). Beta values for the final model of RALG were as below: intercept (-9.794) and preoperative AL (0.664). The postoperative AL was predicted as: postAL = preAL + RALG × log 10 ([postAge + 0.6]/[preAge + 0.6]). The mean prediction error was -0.003 (95% CI, -0.386 to 0.3791) mm and the mean absolute percentage error was 1.93% (95% CI, 0.73% to 3.14%). A Python-based calculator was developed to use the predicted AL in selecting IOL power and setting undercorrection. The AL growth of patients with MFS followed a logarithmic pattern and ceased at about age 15. A prediction model of postoperative AL was established for individual MFS patients between 3 and 15 years old, which could potentially optimize the IOL power selection.