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Retropupillary iris-claw intraocular lens in ectopia lentis in Marfan syndrome

Authors Faria M, Pinto Ferreira N, Neto E

Received 14 February 2016

Accepted for publication 7 April 2016

Published 17 June 2016 Volume 2016:9 Pages 149—153


Checked for plagiarism Yes

Review by Single-blind

Peer reviewer comments 4

Editor who approved publication: Dr Scott Fraser

Video abstract presented by Mun Yueh de Faria

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Mun Yueh Faria,1 Nuno Ferreira,2 Eliana Neto,1

1Vitreo Retinal Department, 2Ophthalmology Department, Santa Maria Hospital, Lisbon, Portugal

Objective: To report visual outcomes, complication rate, and safety of retropupillary iris-claw intraocular lens (ICIOL) in ectopia lentis in Marfan syndrome (MFS).
Design: Retrospective study.
Methods: Six eyes of three MFS patients with ectopia lentis underwent surgery for subluxation lens and retropupillary ICIOL implantation from October 2014 to October 2015 at the Department of Ophthalmology, Santa Maria Hospital in Lisbon, Portugal. Demographics, preoperative and postoperative best-corrected visual acuity (BCVA), and intraocular pressure were evaluated. Endothelium cell count was assessed using specular microscopy; anterior chamber depth was measured using Pentacam postoperatively; and intraocular lens position was viewed by ultrasound biomicroscopy. All patients were female; mean age was 20±14.264 years (range: 7–38 years).
The average follow-up period was 6.66 months (range: 4–16 months). Preoperative BCVA was 0.568±0.149 logMAR units, and postoperative BCVA was 0.066±0.121 logMAR units. The mean BCVA gain was –0.502±0.221 on the logMAR scale. Postoperative average astigmatism and intraocular pressure were 1.292±0.697 mmHg (range: 0.5–2.25 mmHg) and 16 mmHg (range: 12–18 mmHg), respectively. The average endothelial cell density decreased from 3,121±178 cells/mm2 before surgery to 2,835±533 cells/mm2 after surgery (measured at last follow-up visit) and in the last follow-up, representing an average endothelial cell loss of 9.16%. Mean anterior chamber depth was 4.01 mm (±0.77 mm), as measured by Pentacam. No complications were found intra- or postoperatively in any of the six studied eyes.
Conclusion: Retropupillary ICIOL implantation is a safe and effective procedure in the treatment of aphakia in MFS eyes, without capsular support after surgery for ectopia lens. The six eyes that underwent lensectomy and retropupillary ICIOL implantation have had excellent visual outcomes with no complications so far.

retropupillary iris claw IOL, dislocated lens, aphakia

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