Posterior iris-claw aphakic intraocular lens implantation in subluxated lenses due to Marfan syndrome.
OBJECTIVE
To evaluate the indications, visual outcomes, and complication rate after posterior implantation of an iris-claw aphakic intraocular lens (IOL) in subluxated lenses due to Marfan syndrome.


METHODS
Eyes without adequate capsular support had posterior chamber iris-claw aphakic IOL implantation between 2006 and 2012.


RESULTS
This retrospective cohort study comprised 13 eyes of 10 patients (7 female, 3 male; mean age ± standard deviation, 34.7 ± 19.6; range 9-61 years). The mean follow-up was 37 months (range 6-74 months). The mean final postoperative best-corrected visual acuity was significantly (0.24 ± 0.36 logMAR) better at the last follow-up than 1 day preoperatively (0.72 ± 0.46 logMAR) (p<0.05). There was no significant change in intraocular pressure before and after surgery. The mean endothelial cell density decreased from 2793 ± 478 cells/mm2 preoperatively to 2637 ± 612 cells/mm2 at last follow-up, representing a mean endothelial cell loss of 5.6%. Complications included early transient postoperative hypotony in 2 eyes (15.4%), slight persistent pupil ovalization in 1 eye (7.7%), and retinal detachment in 1 eye (7.7%).


CONCLUSIONS
The posterior implantation technique of aphakic iris-claw IOL provided good visual outcomes with a favorable complication rate and can be used as a reasonable alternative in subluxated lenses due to Marfan syndrome without adequate capsular support.
From the Department of Ophthalmology, Charité, University Medicine Berlin, Berlin - Germany.
Johannes
J
Gonnermann
Necip
N
Torun
Matthias K J
MK
Klamann
Anna-Karina
AK
Maier
Christoph
C
von Sonnleithner
Eckart
E
Bertelmann
D000293:Adolescent; D000328:Adult; D002452:Cell Count; D002648:Child; D055954:Corneal Endothelial Cell Loss / Q000503:physiopathology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007429:Intraocular Pressure / Q000502:physiology; D007498:Iris / Q000601:surgery; D019654:Lens Implantation, Intraocular / Q000379:methods*; D007906:Lens Subluxation / Q000503:physiopathology / Q000601:surgery*; D007910:Lenses, Intraocular; D008297:Male; D008382:Marfan Syndrome / Q000503:physiopathology / Q000601:surgery*; D008875:Middle Aged; D018918:Phacoemulsification / Q000379:methods*; D011183:Postoperative Complications; D011474:Prosthesis Design; D012189:Retrospective Studies; D014065:Tonometry, Ocular; D016896:Treatment Outcome; D014792:Visual Acuity / Q000502:physiology; D055815:Young Adult