Purpose: To analyze the visual outcomes,intraoperative and postoperative complications of Cionni ring implantation in eyes with a subluxated lens associated with Marfan Syndrome.
Methods: This case series comprised 15 eyes of 12 patients aged 19 to 56 years with a subluxated lens secondary to Marfan's syndrome operataed at the departament of ophtalmology, Toronto Western Hospital between 2003 and 2007. A 2-eyelet Cionni ring and an AcrySof®(Alcon) foldable intraocular lens (IOL) was implanted in 13 eyes. The Cionni ring was secured in position with a transscleral suture knotted to the ring's hook, avoiding peripheral perforation of the capsular bag. Two eyes had trans scleral IOL fixation in the ciliary sulcus. Best-corrected visual acuity (BCVA), wavefront evaluation of eye aberration, and complication rates were analyzed.
Results: In all eyes capsular bag centration was excellent. Preoperative visual acuity ranged from 20/50 to counting fingers, and improved to better than 20/40 in all eyes. Mean follow up duration was 14 + 9.49 months. The most frequent postoperative complication was posterior capsule opacification, which occurred in 3 eyes (18.7%), 2 of which required a neodymium:YAG posterior capsulotomy. No eye developed retinal detachment. Total eye aberration, tilt and high-order aberrations with a 6-mm pupil diameter decreased significantly after surgery (n=5): Total eye aberration decreased from a mean of 14.8 + 5.5 preoperatively to 2.1+ 4.3 microns after the operation. Tilt was decreased from 4.1+ 2.5 to 0.12+ 2.1 microns ,and high-order aberrations decreased from 4.37+ 3.8 microns, before the operation, to 1.47+ 3.5 after the operation.
Conclusion: Cionni ring implantation is an acceptable procedure to correct limited lens subluxation, preserves the capsular bag, and has few complications (during 14 months of follow up)in patients with Marfan Syndrome.
- Marfan's synrom
- ectopia lentis
- enocapsular ring