Bimanual irrigation-aspiration for ectopia lentis and use of a small incision for 4-point scleral-sutured foldable intraocular lens and anterior vitrectomy in patients with Marfan syndrome

Abstract

Purpose:This study evaluated bimanual intracapsular irrigation-aspiration for ectopia lentis with use of a small incision for 4-point scleral fixation of a foldable posterior-chamber intraocular lens (IOL) and anterior vitrectomy in patients with Marfan syndrome.Methods:We performed a retrospective study of 18 eyes from 10 patients with Marfan syndrome who underwent surgical intervention for ectopia lentis at our clinic between July 2012 and September 2018. In this study, intraoperative and postoperative complications, uncorrected visual acuity, best-corrected visual acuity, spherical equivalent, intraocular pressure, and endothelial cell density were evaluated.Results:No intraoperative complications were reported. In all cases, early postoperative evaluation revealed a clear cornea, round pupil, and well-centered IOL. Mean logMAR uncorrected visual acuity improved from 1.09 preoperatively to 0.56 postoperatively (P < 0.05). Mean logMAR best-corrected visual acuity improved from 0.45 preoperatively to 0.17 postoperatively (P < 0.05). Aside from transient ocular hypertension, no postoperative complications were reported.Conclusion:The combined surgical technique presented above yields excellent visual outcomes with an extremely low incidence of complications. This approach is simple, safe, and effective in the treatment of ectopia lentis in patients with Marfan syndrome.

Scleral fixation of hydrophobic acrylic intraocular lenses using a suture burial technique

“…This large incision may result in slow visual recovery, intraoperative hypotony, and detachment of the retina. [ 1 2 ] For this reason, single-piece acrylic (SPA) foldable IOLs have been used for scleral fixation to reduce the size of the surgical wounds. [ 3 4 5 ] Specially designed, SPA foldable IOLs have been designed for transscleral suture fixation, but they are not useful for in-the-bag implantation because of their large haptic size.…”

<p>Double-Flanged polypropylene Suture for Scleral Fixation of Cionni Capsule Tension Ring</p>

“…A polytetrafluoroethylene CV-8 suture has been used for scleral fixation off label and to date has had excellent longevity. 3 This described technique is a simple, time sparing and minimally invasive method for achieving good bag centration. It eliminates the need of conjunctival peritomy, subconjunctival vessels cautery and scleral fashioning of a flap, pocket or a groove.…”

Intraocular lens implantation in the absence of capsular support: scleral-fixated vs retropupillary iris-claw intraocular lenses

“…30 Largely, the rate of endothelial cell loss after the SF IOL (2.1% to 27%) and RP-IC IOL (3.7% to 11.9%) implantation seems to be comparable. 23,27,33,41,42,51,56,63,[68][69][70][71][72][73][74][75] The incidence of corneal edema, an endothelial cell loss-associated complication, has also been found to be similar in both types of implantations. 23,36 The rate of CME in the published literature seemed to be variable.…”

“…Chronic uveitis due to persistent vitreous traction or chafing against uveal tissues may also lead to secondary glaucoma. 103 Hazar et al [11][12][13][16][17][18][19][20][22][23][24][25][27][28][29][30][31][38][39][40][41][42][43][44][45][46][47][48][49][50][51] 1%, 36.36% 8,23,32,33,37,41,47,48,[52][53][54][55][56][57][58][59][60][61][62] Glaucoma 0%, 17% 11,…”

“…Mean CDVA (Snellen equivalent) 20/22, 20/88 11,12,14,17,24,27,28,30,31,42,44,49,51,78,80,88 (1 d -83 mo) 20/23.5, 20/87*, 8,32,52,54,55,61,71,72,74,81,85,92,93 (1 mo -8 y) CDVA of 20/40 or better 29%, 91% 13,[18][19][20]38,44,[48][49][50]63,64,70,78,80,94 70%, 90% 48,53,56,58,61,87,95 Mean UDVA (Snellen equivalent) 20/65, 20/100 24,…”