Abstract:

Objective To evaluate the clinical effects of phacoemulsificatio or limbal-approach lensectomy and vitrectomy combined with scleral-fixated intraocular lens(IOL) implantation for ectopia lentis in Marfan syndrome.  Design Retrospective case series Participants 10 patients (18 eyes) with ectopia lentis in Marfan syndrome were reviewed. Methods 3 patient (older than 12 years, 5 eyes) were treated with phacoemulsification combined with the scleral-fixated IOL implantation. The other 7 patients (younger than 12 years, 13 eyes) were treated with limbal-approach lensectomy and vitrectomy combined with scleral-fixated IOL implantation. The mean follow-up period was (1.40±1.02) years  (range 0.5 to 3 years). Main Outcome Measures The changes of visual activity, intraocular pressure and surgery complications. Results The mean best-corrected visual acuity (BCVA) of the 18 eyes improved significantly, from preoperative 0.29±0.20,  to 0.51±0.24 (P=0.008). The mean BCVA of phacoemulsification group was 0.17±0.04 before operation, which significantly improved to 0.41±0.16 after operation (P=0.026). The mean BCVA of lensectomy group was (0.34±0.22) before operation, and (0.55±0.25) after operation. The improvement was significant (P=0.000). The pre- and post-operative visual acuity change was no significant between the two groups (P=0.062). The mean pre-opertive spherical equivalent refractive error was -2.76±14.1 diopters (D), which improved to -0.79±1.95 D after operation. Conclusion The two surgical approaches to treat ectopia lentis are both safe and effective. There was no significant difference between the two approaches in terms of visual improvement and refractive error. (Ophthalmol CHN, 2016, 25: 86-89)

Key words: Marfan syndrome, ectopia lentis, phacoemulsification, scleral-fixated intraocular lens implantation, vitrectomy, lensectomy