Bimanual irrigation-aspiration for ectopia lentis and use of a small incision for 4-point scleral-sutured foldable intraocular lens and anterior vitrectomy in patients with Marfan syndrome

• Published in: Indian journal of ophthalmology Vol. 67; no. 10; pp. 1629 - 1633
• Main Authors: Wang, Zhenmao, Lu, Yan, Xiao, Kailin, Gao, Ying, He, Jing, Zhang, Shaobin, Wang, Geng, Zhang, Mingzhi
• Format: Journal Article
• Language: English
• Published: India Wolters Kluwer India Pvt. Ltd 01.10.2019; Medknow Publications and Media Pvt. Ltd; Medknow Publications & Media Pvt. Ltd; Wolters Kluwer - Medknow; Wolters Kluwer Medknow Publications
• Subjects: Acuity; Adolescent; Adult; Anterior vitrectomy; Aspiration (Physiology); Astigmatism; Care and treatment; Cell density; Child; Child, Preschool; Cornea; Ectopia Lentis - diagnosis; Ectopia Lentis - etiology; Ectopia Lentis - surgery; ectopia lentis aspiration; Endothelial cells; Female; foldable 4-point scleral fixation IOL; Follow-Up Studies; Glaucoma; Health aspects; Humans; Intraocular lenses; Iris - surgery; Irrigation (Medicine); Lavage; Lens Implantation, Intraocular - methods; Male; Marfan syndrome; Marfan Syndrome - complications; Marfan Syndrome - diagnosis; Marfan's syndrome; Medical research; Methods; Original; Paracentesis - methods; Polymethyl methacrylate; Postoperative complications; Prosthesis Design; Retrospective Studies; Sclera - surgery; small incision; Surgery; Surgical outcomes; Surgical techniques; Suture Techniques; Therapeutic Irrigation - methods; Visual Acuity; Vitrectomy; Vitrectomy - methods; Young Adult; India; Japan; ectopia lentis aspiration; Anterior vitrectomy; foldable 4-point scleral fixation IOL; Marfan syndrome; small incision
• ISSN: 0301-4738; 1998-3689
• DOI: 10.4103/ijo.IJO_250_19

Purpose: This study evaluated bimanual intracapsular irrigation-aspiration for ectopia lentis with use of a small incision for 4-point scleral fixation of a foldable posterior-chamber intraocular lens (IOL) and anterior vitrectomy in patients with Marfan syndrome. Methods: We performed a retrospective study of 18 eyes from 10 patients with Marfan syndrome who underwent surgical intervention for ectopia lentis at our clinic between July 2012 and September 2018. In this study, intraoperative and postoperative complications, uncorrected visual acuity, best-corrected visual acuity, spherical equivalent, intraocular pressure, and endothelial cell density were evaluated. Results: No intraoperative complications were reported. In all cases, early postoperative evaluation revealed a clear cornea, round pupil, and well-centered IOL. Mean logMAR uncorrected visual acuity improved from 1.09 preoperatively to 0.56 postoperatively (P < 0.05). Mean logMAR best-corrected visual acuity improved from 0.45 preoperatively to 0.17 postoperatively (P < 0.05). Aside from transient ocular hypertension, no postoperative complications were reported. Conclusion: The combined surgical technique presented above yields excellent visual outcomes with an extremely low incidence of complications. This approach is simple, safe, and effective in the treatment of ectopia lentis in patients with Marfan syndrome.