Monoscleral fixation of IOL after extracapsular extraction of subluxated lenses in patients with Marfan syndrome

ABSTRACT

Purpose: To describe a technique of monoscleral fixation of the intraocular leras (lOL) after extracapsular extraction of subluxated lens in patients with Marfan syndrome. Design: Noncomparative, interventional case series. Methods: A retrospective study was conducted on 14 eyes of 7 consecutive patients with subluxated lens associated with Marfan syndrome. Surgery was indicated when 1) a lens border was observed in the pupil area with the pupil under normal lighting causing glare; or 2) the best corrected visual acuity was less than 20/70; or 3) the patient complained of monocular diplopia. Patients with a history of glaucoma, retinal detachment, trauma or other systemic diseases were excluded. Results: The mean postoperative follow-up was 15.43 ± 9.33 months (range, 6 to 30 months). The best spectacle-corrected visual acuity varied from 20/25 to 20/60, where 71.43 percent reached 20/30 or better. No case showed a worsening of visual acuity, nor were there any intraoperative or postoperative complications (intraocular lens decentration, pupilar block, glaucoma or retinal detachment). The most frequent postoperative complication was astigmatism, observed in 3 eyes (21.43 percent) presenting values greater than 1.5 D, Conclusions: This technique showed very good surgical and visual results and few complications, providing a surgical option for cases of ectopia lentis assoeiated wìth Marfan syndrome, especially in some countries or regions where phacoemulsification is not available.