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Risk factors for postoperative complications in lensectomy–vitrectomy with or without intraocular lens placement in ectopia lentis associated with Marfan syndrome
  1. Fan Fan,
  2. Yi Luo,
  3. Xin Liu,
  4. Yi Lu,
  5. Tianyu Zheng
  1. Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai, China
  1. Correspondence to Dr Yi Luo, Department of Ophthalmology, Eye & ENT Hospital, Fudan University, 83 Fenyang Road, Shanghai 200031 China; yeeluo1106{at}163.com

Abstract

Aims To analyse the surgical outcomes and postoperative complications of 23-G lensectomy–vitrectomy in the management of ectopia lentis in patients with Marfan syndrome.

Methods This retrospective study evaluated all patients with Marfan syndrome who received 23-G lensectomy–vitrectomy either through pars plana or the limbus for management of ectopia lentis between 1 January 2008 and 31 December 2011 at Eye and ENT Hospital of Fudan University.

Results A total of 64 eyes of 39 patients with Marfan syndrome (28 males and 11 females) underwent lensectomy–vitrectomy as a primary procedure for ectopia lentis. The best-corrected visual acuity improved significantly from 0.5 (0.3–0.7) LogMar preoperatively to 0.3 (0.1–0.5) LogMar (p<0.01) at the last postoperative visit. Retinal detachment (RD) occurred in 11 eyes. Comparing the characteristics between those patients with detached and non-detached retinas, a more severe grade of lens dislocation (p=0.001) and higher axial myopia (p=0.035) were observed among those with detached retinas, whereas there were no significant differences between the two groups in terms of age (p=0.624), pseudophakia or aphakia (p=0.672), and preventive photocoagulated breaks (p=0.719). There was no significant difference in the incidence of RD between the scleral-fixated intraocular lens group and anterior chamber intraocular lens group (p=0.412).

Conclusions Development of RD in patients with Marfan syndrome remains a risk following surgery for ectopia lentis. Caution should be taken in eyes with severe lens dislocation or high axial myopia when planning the surgery.

Keywords
  • pars plana approach
  • limbal approach
  • Marfan syndrome
  • ectopia lentis
  • retinal detachment

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