Purpose:To compare clinical outcomes and complications of eyes implanted with iris claw AC-IOLs and PC-IOLs after phacoemusification in management of severe subluxated lenses of Marfan’s Syndrome.
Methods:The retrospective study was comprised of 71 eyes of 49 cases with severe subluxated lenses due to Marfan’s Syndrome. Patients were performed phacoemulcification combined with one of the following IOL implantations according to the severity of lens subluxation: Lens dislocation range was between 180°to 270°:transsclerally sutured PC-IOLs; Lens dislocation range was ≥ 270°: Artisan IOLs implantation. Indexes such as UCVA、BCVA、IOP、corneal endothelium loss、AC flare and cell、PCO、IOL position、intraoperative and postoperative complications were observed postoperatively.
Results:From 6 months to 2 years’ follow up, UCVA and BCVA were both increased. There was no statistically significance between two groups both in loss rate of corneal endothelium and AC flare and cell counts. PCO rate of two groups were 32% and 15% respectively, and only 3 eyes of group 1 needed Nd:YAG capsulotomy. Images from UBM and anterior segment OCT showed AC IOLs were centered. But in sulcus fixation group, tilt and decentration of IOLs was observed in 13 cases, and pupil capture in 6 cases, 2 of which needed surgical interventions. Prolapse of vetreous was found in 21 cases and no more complications was observed intraoperatively. Postoperative complications included secondary glaucoma and retina detachment. No more complications such as corneal decompensation, cystoid detachment and suprachoroidal hemorrhage was found.
Conclusion:Compared with traditional ECCE or ICCE, phacoemulsification can increase visual function and decrease complications of surgery. Modern AC-IOLs and iris hooks can simplify the procedures and are promising treatments for severe lens dislocation. Selecting a proper surgical technique according to the degree of lens subluxation is the key to the best restoration of visual function of the patients with Marfan’s Syndrome. |
