ABSTRACT.Purpose: To evaluate corneal curvature, pachymetry, and endothelial cell density (ECD) in Marfan syndrome (MFS). Methods: A case-control study in which K values, pachymetry, and ECD were compared in 39 MFS eyes and 40 control eyes matched for age and refraction was conducted. MFS eyes with lens subluxation also were compared with eyes without subluxation. Results: The mean K med value in MFS eyes was lower than in the control eyes, 42.2 ± 1.9 versus 43.4 ± 1.4 dioptres (D), respectively (p = 0.02). Fifteen MFS eyes (38%) and three control eyes (8%) had K med values below 41.5 D (p = 0.0012). MFS eyes had generally more corneal astigmatism than control eyes, 1.1 ± 0.9 versus 0.8 ± 0.4 D (p = 0.035), and MFS eyes with lens subluxation had more corneal astigmatism than those without, 1.6 ± 1.1 versus 0.6 ± 0.3 D (p = 0.0002). Nine MFS eyes with corneal astigmatism exceeding 1.5 D also had a subluxated lens. No eyes had keratoconus. The mean pachymetry value was lower in MFS eyes compared to the controls, 485 ± 54.5 versus 514 ± 37.3 lm (p = 0.007); 24 MFS eyes (62%) and 10 control eyes (25%) had measurements below 500 lm (p = 0.01). The mean ECD values were similar in MFS and control eyes, 2815 ± 430 versus 2858 ± 458 cells ⁄ mm 2 (p = 0.66). The mean K value, pachymetry, and ECD values did not differ between MFS eyes with and without lens subluxation. Conclusion: Decreased K values and pachymetry could indicate MFS regardless of subluxation. High corneal astigmatism is associated with subluxation in MFS. Subluxation should be identified in MFS eyes with high corneal astigmatism.

ABSTRACT.Purpose: To compare the degree of lens glistenings associated with three intraocular lenses (IOLs) of different materials and examine the relationship between the dioptric power of the optics and lens glistenings in a long-term study. Setting: St. Erik Eye Hospital, Stockholm, Sweden. Methods: Forty-six eyes of 46 patients underwent standard phacoemulsification and implantation with a heparin-surface-modified (HSM) polymethylmethacrylate (PMMA) IOL, a silicone IOL or a hydrophobic acrylic IOL. Evaluations of the patients and the glistenings were conducted 11.3-13.4 years postoperatively. The glistenings were examined using Scheimpflug imaging and subsequently analysed using an image analysis program. Results: The median follow-up time was 12.2 years (range, 11.3-13.4). The hydrophobic acrylic IOL had significantly more lens glistenings than the silicone (p = 0.003) and the PMMA (p = 0.000) IOLs. The silicone IOL had significantly more lens glistenings than the PMMA lens (p = 0.048). The IOL power did not affect the degree of lens glistenings in the hydrophobic acrylic IOL group (p = 0.64). The other groups had too little lens glistenings to evaluate the relationship. Conclusion: In this long-term follow-up study, the hydrophobic acrylic IOL had a significantly higher degree of lens glistenings compared to the silicone and PMMA IOLs. The PMMA IOL had almost no lens glistenings. The IOL dioptric power was not significantly correlated with the degree of lens glistenings associated with the hydrophobic acrylic IOL.

<H4>PURPOSE</H4> <P>To evaluate the surgical outcome and adverse events associated with correction of myopia and hyperopia with a phakic refractive lens (PRL), and to determine the random errors of the analytical methods used in the trial. </P> <H4>METHODS</H4> <P>In this prospective clinical study, 14 myopic and 6 hyperopic PRLs were implanted in 20 eyes of 20 patients from April to November 2002. Follow-up included evaluation of the PRL rotation with retroillumination photography, the distance between the PRL and crystalline lens with Scheimpflug images, laser flare meter, endothelial cell count, uncorrected (UCVA) and best spectacle-corrected visual acuity (BSCVA), refraction, intraocular pressure, and induced cataract. The random errors of the measurements with laser flare meter were 17%, with Scheimpflug images 10%, and with endothelial cell count 2.8%. </P> <H4>RESULTS</H4> <P>Postoperatively, 25% of eyes gained 2 or more lines and no eye lost 2 or more lines of BSCVA. Mean UCVA was 0.89±0.34. Laser flare values returned to baseline at 3 months and had no changes at 1 or 2 years (<I>P</I>>.05). The PRL rotated less during the second year than the first year. The distance between the PRL and crystalline lens was less at 1 year than at baseline (<I>P</I><.05) but had no change during the second year. No statistically significant endothelial cell loss was noted between 1 week and 1 or 2 years postoperatively (<I>P</I>>.05). Two (10%) eyes developed pupillary block, one (5%) hyperopic eye showed unexpected postoperative myopia, and in another hyperopic eye (5%) the horizontal iris transillumination defects were noticed at 1 year combined with slight pupil ovalization at 2 years. No induced cataract, glaucoma, or inflammation was observed. </P> <H4>CONCLUSIONS</H4> <P>Safety and efficacy indexes were high at 2-year follow-up. The distance between the PRL and crystalline lens decreased by 59% during the first year but seemed to stabilize thereafter. The PRL rotated in only a few eyes after the first year. [<CITE>J Refract Surg.</CITE> 2008;24:507-515.]</P> <H4>ABOUT THE AUTHORS</H4> <P>From St Eriks Eye Hospital (Koivula, Taube) and the Department of Clinical Neuroscience, Karolinska Institute (Koivula, Zetterström), Stockholm, Sweden; and Ullevål University Hospital (Zetterström), Oslo, Norway. </P> <P>The authors have no proprietary or financial interest in the materials presented herein. </P> <P>This study was presented at the 9th ESCRS Winter Refractive Surgery Meeting, February 4-6, 2005, Rome, Italy; and ASCRS Annual Symposium & Congress, April 16-20, 2005, Washington, DC. </P> <P>The authors thank Professor Bo Lindstrom who contributed to the statistical analysis. </P> <P>Correspondence: Annemari Koivula, MD, St Eriks Eye Hospital, S-112 82, Stockholm, Sweden. E-mail: <A HREF="mailto:annemari.koivula@sankterik.se">annemari.koivula@sankterik.se</A> </P> <P>Received: May 24, 2006</P> <P>Accepted: May 16, 2007</P> <P><B>Posted online: October 31, 2007 </B></P>

No abstract