Intraocular Lens Subluxation in Marfan Syndrome

Bolaños-Jiménez, Rodrigo; Paulina, López-Lizárraga E; Francesc, March de R; Eduardo, Telich-Tarriba J; Navas, Alejandro

doi:10.2174/1874364101408010048

Cited by 13 publications

(8 citation statements)

References 7 publications

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“…In myopia, the mechanism for lens subluxation may be different than in pseudoexfoliation [ 4 , 27 ]. Lens subluxation may be the result of progressive overstretching of the processes, and progressive elongation of the fibers, rather than degeneration and weakening without elongation which is more likely in pseudoexfoliation.…”

Section: Discussionmentioning

confidence: 99%

Axial Length of the Eyeball Is Important in Secondary Dislocation of the Intraocular Lens, Capsular Bag, and Capsular Tension Ring Complex

Kłysik

Kaszuba-Bartkowiak

Jurowski

2016

Journal of Ophthalmology

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Purpose. To analyze the patients with secondary dislocation of CTR and IOL within 5 years from cataract surgery, to determine predisposing factors. Methods. 16 eyes of 15 patients aged 66.2 ± 6.7 (from 49 to 82) with CTR/IOL complex dislocation within 5 years from cataract surgery were compared with 26 patients aged 67.1 ± 7.2 (from 53 to 85), implanted with CTR during cataract surgery to manage zonule dehiscence and did not dislocate for at least 5 years, in respect of cause, axial length and IOL power, refraction, coexistent pathology, and trauma. Results. Axial length of the eyeball was 23.8 ± 1.3 (from 21 to 29) in the group of patients with CTR/IOL dislocation and 20.7 ± 1.2 (from 19 to 24) in patients with no dislocation present (p = 0.008). Crystalline lens dislocation was diagnosed before surgery in 13 of 16 patients with CTR/IOL complex dislocation as opposed to 7 of 26 eyes in the control group (p = 0.01). Pseudoexfoliation was present in 50% and 58% in both groups, respectively. Traumatic dislocation was present in 8 patients, none of them with CTR/IOL dislocation (p = 0.04). Conclusion. Longer axial length may contribute to the failure of the CTR to prevent in-the-bag IOL dislocation. Traumatic dislocation appears to be well fixed with the CTR.

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Section: Discussionmentioning

confidence: 99%

Axial Length of the Eyeball Is Important in Secondary Dislocation of the Intraocular Lens, Capsular Bag, and Capsular Tension Ring Complex

Kłysik

Kaszuba-Bartkowiak

Jurowski

2016

Journal of Ophthalmology

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“…Although absence of capsular/zonular support can result from various eye conditions, including Marfan syndrome [ 7 ], familial or idiopathic ectopia lentis, high myopia, vitrectomy surgery [ 8 ], and posterior capsule rupture during cataract surgery, one of the main causes is ocular trauma, which can be further classified into open and closed globe injuries [ 9 ]. Open globe injuries, such as ocular laceration or rupture, usually damage the structural integrity of the eyeball, a delicate optical system, which may affect the precise localization of a transsclerally sutured posterior-chamber IOL and cause poor optical quality of the eyeball [ 5 ].…”

Section: Introductionmentioning

confidence: 99%

Tilt, Decentration, and Internal Higher-Order Aberrations of Sutured Posterior-Chamber Intraocular Lenses in Patients with Open Globe Injuries

Zhu

Zhang

et al. 2017

Journal of Ophthalmology

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Purpose To evaluate the tilt, decentration, and internal higher-order aberrations (HOAs) of sutured posterior-chamber intraocular lenses (IOLs) in patients with open globe injuries. Methods 46 consecutive patients (47 eyes) who underwent transsclerally sutured IOL implantation were enrolled in this prospective cohort study. Nineteen eyes had a history of open globe injury. The tilt and decentration of the IOLs and the visual quality were measured 1 month after surgery. Results The horizontal tilt and decentration of the IOLs in the open-globe-injury group were significantly higher than those in the control group (both P < 0.05). In the open-globe-injury group, the horizontal decentration was significantly greater in the limbus-sclera-involved group (n = 11) than in the only-cornea-involved group (n = 8, P = 0.040). The internal coma, 3rd-order, and total HOA values at pupil sizes of 4 mm (P = 0.006) and 6 mm (P = 0.013) were significantly higher in the open-globe-injury group than in the controls. Consequently, the optical quality data for the modulation transfer function and the Strehl ratio (all P < 0.05) were significantly poorer in the open-globe-injury group. Conclusions Open globe injuries damage the structural integrity of the eyeball, resulting in more-misaligned sutured IOLs and poorer visual quality.

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“…Marfan syndrome is an autosomal dominant inherited connective tissue disease, but only about 75% of the patients have an affected parent, 25% being de novo mutations. To reduce mortality and increase quality of life, frequent cardiovascular surveillance to prevent sudden aortic rupture and ophthalmological tests are needed, amongst others [33,34,35]. In the second scenario, the impact of poor uptake is likely to impede research and further test refinement because less data are available.…”

Section: Consequences Of Obligatory Genetic Data Disclosurementioning

confidence: 99%

Is It Desirable that I Must Disclose My Genetic Data to Swiss Private Medical Insurances?

Bräm

Szucs²

2016

Public Health Genomics

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Genetic testing has far-reaching consequences, not only in terms of immediate patient management and the wider implications for the patient and their families, but also with respect to disclosure to insurance companies. The focus of this review is the controversial but important topic of the use of genetic data in private medical insurance. We discuss the current legal regulation of genetic data in the context of Swiss insurance, what type(s) of information is relevant to insurance companies, and why ‘genetic exceptionalism' (the notion that genetic data has special status) persists. Furthermore, we discuss the sensitive area of handling genetic data from children. The consequences of legal regulation of disclosure of genetic information are considered, particularly from the economic perspective. Finally, we examine how legal conditions correspond to current insurance practice and contrast the Swiss system with the handling of genetic data in other countries in the context of private insurance. Switzerland has adopted fairly ‘laissez-faire' regulations compared to other countries, and the public need education on the potential effects of genetic testing on their insurance, especially with respect to direct-to-consumer genetic testing, where there is no consultation from a qualified doctor, or when minors are involved.

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Intraocular Lens Subluxation in Marfan Syndrome

Cited by 13 publications

References 7 publications

Axial Length of the Eyeball Is Important in Secondary Dislocation of the Intraocular Lens, Capsular Bag, and Capsular Tension Ring Complex

Axial Length of the Eyeball Is Important in Secondary Dislocation of the Intraocular Lens, Capsular Bag, and Capsular Tension Ring Complex

Tilt, Decentration, and Internal Higher-Order Aberrations of Sutured Posterior-Chamber Intraocular Lenses in Patients with Open Globe Injuries

Is It Desirable that I Must Disclose My Genetic Data to Swiss Private Medical Insurances?

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