J Korean Ophthalmol Soc.  2009 Aug;50(8):1174-1178. 10.3341/jkos.2009.50.8.1174.

Transscleral IOL Fixation With Preserved Anterior Vitreous Face in Marfan Syndrome With Ectopia Lentis

• Choi HW
• Kim EH
• Kim WS

• KMID: 2212530
• DOI: http://doi.org/10.3341/jkos.2009.50.8.1174

Abstract

PURPOSE
To evaluate the safety and efficacy of transscleral intraocular lens (IOL) fixation while preserving the anterior vitreous face in treating ectopia lentis of Marfan syndrome. METHODS: This study included six patients (12 eyes) who had undergone surgical intervention for ectopia lentis with or without lenticular opacity. We compared the best-corrected visual acuity (BCVA) before and after the surgery and evaluated perioperative complications. RESULTS: The mean age at the time of surgery was 18.2+/-10.7 years. The mean follow-up period was 11.2+/-7.1 months. Mean BCVA scores changed from 0.96+/-0.37 (LogMar Value) to 0.14+/-0.17 (LogMar Value). All patients showed more than two lines of improvement in visual acuity. In two eyes, pupillary capture was found. Medically controllable intraocular pressure elevation was found in three eyes. CONCLUSIONS: This study suggests that transscleral IOL fixation with a preserved anterior vitreous face can be a safe and effective technique in treating the ectopia lentis of Marfan syndrome.

Keyword

Ectopia Lentis; Marfan syndrome; Transscleral IOL Fixation

MeSH Terms

Ectopia Lentis
Eye
Follow-Up Studies
Humans
Intraocular Pressure
Lenses, Intraocular
Marfan Syndrome
Visual Acuity

Figure

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  Figure 1. Ophthalmic viscosurgical device is injected through the loose zonules enough to separate the posterior capsule from the anterior vitreous face.

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  Figure 2. Attached zonules can be separated with intraocular scissors.

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  Figure 3. As the remained zonules and capsular remnants (arrows) indicate the level of the anterior vitreous face, a needle can be passed across the chamber and to the ciliary sulcus on the opposite side without breaking the anterior vitreous face.

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  Figure 4. Location of the needle in the sulcus can be detected by an elevation of the sclera (arrow) made by gentle pressure of the needle against the scleral wall.

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  Figure 5. Comparison of preoperative and postoperative best corrected visual acuity (BCVA) of the patients.

Reference

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