Risk factors for postoperative complications in lensectomy-vitrectomy with or without intraocular lens placement in ectopia lentis associated with Marfan syndrome.
OBJECTIVE
To analyse the surgical outcomes and postoperative complications of 23-G lensectomy-vitrectomy in the management of ectopia lentis in patients with Marfan syndrome.


METHODS
This retrospective study evaluated all patients with Marfan syndrome who received 23-G lensectomy-vitrectomy either through pars plana or the limbus for management of ectopia lentis between 1 January 2008 and 31 December 2011 at Eye and ENT Hospital of Fudan University.


RESULTS
A total of 64 eyes of 39 patients with Marfan syndrome (28 males and 11 females) underwent lensectomy-vitrectomy as a primary procedure for ectopia lentis. The best-corrected visual acuity improved significantly from 0.5 (0.3-0.7) LogMar preoperatively to 0.3 (0.1-0.5) LogMar (p<0.01) at the last postoperative visit. Retinal detachment (RD) occurred in 11 eyes. Comparing the characteristics between those patients with detached and non-detached retinas, a more severe grade of lens dislocation (p=0.001) and higher axial myopia (p=0.035) were observed among those with detached retinas, whereas there were no significant differences between the two groups in terms of age (p=0.624), pseudophakia or aphakia (p=0.672), and preventive photocoagulated breaks (p=0.719). There was no significant difference in the incidence of RD between the scleral-fixated intraocular lens group and anterior chamber intraocular lens group (p=0.412).


CONCLUSIONS
Development of RD in patients with Marfan syndrome remains a risk following surgery for ectopia lentis. Caution should be taken in eyes with severe lens dislocation or high axial myopia when planning the surgery.
Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai, China.
Fan
F
Fan
Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai, China.
Yi
Y
Luo
Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai, China.
Xin
X
Liu
Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai, China.
Yi
Y
Lu
Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai, China.
Tianyu
T
Zheng
D000293:Adolescent; D000328:Adult; D002648:Child; D004479:Ectopia Lentis / Q000601:surgery*; D058450:Endotamponade; D005260:Female; D005466:Fluorocarbons / Q000008:administration & dosage; D006801:Humans; D017075:Laser Coagulation; D019654:Lens Implantation, Intraocular / Q000379:methods*; D007908:Lens, Crystalline / Q000601:surgery*; D008297:Male; D008382:Marfan Syndrome / Q000150:complications*; D011183:Postoperative Complications; D012163:Retinal Detachment / Q000175:diagnosis / Q000209:etiology*; D012189:Retrospective Studies; D012307:Risk Factors; D016896:Treatment Outcome; D014792:Visual Acuity / Q000502:physiology; D014821:Vitrectomy; D055815:Young Adult
D005466:Fluorocarbons; C073608:perfluorooctane
Marfan syndrome; ectopia lentis; limbal approach; pars plana approach; retinal detachment