Long-term outcome of retro-fixated Iris Claw IOLs in Marfan's syndrome

Session Details

Session Title: Cataract Surgery Special Cases

Session Date/Time: Tuesday 25/09/2018 | 08:00-10:00

Paper Time: 08:42

Venue: Room A3, Podium 1

First Author: : L.Sankaranarayanan INDIA

Co Author(s): :    P. Krishnan   R. Bhat                 

Abstract Details

Purpose:

There is no uniersal consensus as to which IOL to be implanted when there is little capsular support as in Marfan's syndrome.When te equator of the lens bisects pupil, optical correction with glasses is not possible. So surgical intervention becomes necessary.Our purpose was to analyse the long term outcome of aphakic correction with retrofixated iris claw lenses after lens extraction in children with subluxated lens in Marfan's syndrome

Setting:

Comtrust Charitable Eye Hospital, a 100 bedded superspeciality Eye Hospital with a daily outpatient number of 1000 with all subspeciality services.

Methods:

16 eyes of 8 children with Marfans Syndrome were taken up for surgery.14 of them presented with deterioration of vision due to the equator bisecting the pupil. 2 eyes had microspherophakia with one anterior dislocation and one floating lens at the pupillary area.Except one case with anterior subluxation, all had primary retrofixated IOL using Excellens model 5590 with A constant 117.0 . One case presented with anterior dislocation and secondary glaucoma and iris claw IOL imolantation was done 6 months afer the first surgery.They were followed up for a minimum of 3 years.

Results:

 16 eyes of 8 children age ranging from 8 years to 13 years (mean age 10.44) 4 girls and 4 boys .BCVA ranged from 0.8 to 1.5 logMAR preoperatively Postoperatively the best corrected VA at the end of 3 months improved to a mean logMAR .35(0.2 to 0.5)except for one case with anterior dislocated lens who had logMar1.0.Mean astigmatic correction was -1.44D.Mean spherical equivalent refractive error -0.95D. Peaking of pupil seen in 44% of cases.One eye was high myopic and had RD after 1 year.One boy had a traumatic disenclavation and was re-enclavated.

Conclusions:

Retrofixated iris claw IOLs are a feasible option for children with Marfans syndrome where there is no capsular support.Other options like scleral fixation and Ahmad segment fixation with sutures entail the future disintegration of suture and the possibilty of dislocation in the growing eye where collagen deficit is there.Anterior chamber IOLs are hardly considered due to their tendency to produce corneal decompensation and glaucoma.

Financial Disclosure:

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