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Cionni endocapsular ring implantation in Marfan’s Syndrome
  1. Irit Bahar1,
  2. Igor Kaiserman1,
  3. David Rootman1
  1. 1
    Department of Ophthalmology, Toronto Western Hospital, University Health Network, University of Toronto, Toronto, Ontario, Canada
  1. Irit Bahar, Toronto Western Hospital, Toronto, Canada; iritbahar{at}


Objectives: To evaluate 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 included 15 eyes of 12 patients aged 19–56 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) were implanted in 13 eyes. Two eyes had trans-scleral IOL fixation in the ciliary sulcus.

Best-corrected visual acuity, wavefront evaluation of eye aberration and complication rates were analysed.

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. The 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 effective procedure to correct partial lens subluxation and has few complications (during 14 months of follow-up) in patients with Marfan’s Syndrome.

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  • Competing interests: None declared.

  • Abbreviations:

    best-corrected visual acuity


    capsular tension ring


    intraocular lens


    modified capsular tension ring

    PC IOL

    posterior chamber intraocular lens


    posterior capsule opacification

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