Comparison Of Long-Term Visual And Refractive Outcomes Of Different Surgical Techniques In Marfan Syndrome-Associated Crystalline Lens Dislocation
Published 2025 - 43rd Congress of the ESCRS
Reference: PP27.03 | Type: Free paper | DOI: 10.82333/tfv3-d484
Authors: Kendrick Co Shih 1 , Po Yin Wu* 1 , Stephanie Wing-Ki Yuk 1 , Riko Kung 1 , Vishal Jhanji 2 , Louis Tong 3
1Department of Ophthalmology,The University of Hong Kong,Hong Kong Island,Hong Kong, 2Department of Ophthalmology,University of Pittsburgh Medical Center,Pittsburgh,United States, 3Department of Ophthalmology,Singapore National Eye Centre,Singapore,Singapore
Purpose
To compare the long-term visual and refractive outcomes of different surgical techniques in patients with crystalline lens dislocation secondary to Marfan syndrome.
Setting
This single-centre, retrospective study was conducted at the Anterior Segment Surgery Department of Beyoglu Eye Training and Research Hospital, a tertiary referral centre in Istanbul, Türkiye.
Methods
In this retrospective cohort study, between January 2017 and January 2022, patients with crystalline lens dislocation secondary to Marfan syndrome who underwent Cionni ring and in-the-bag intraocular lens implantation (Group 1), phacoemulsification and Z-suture scleral fixation (Group 2) and phacoemulsification and scleral fixation with Yamane technique (Group 3) were included. Preoperative and postoperative 3rd year best corrected visual acuity (BCVA-logMAR) and refractive errors (D) were measured. Postoperative 3rd year intraocular lens (IOL) tilt(°), decentralization(mm) and vector analysis of lenticular astigmatism were evaluated.
Results
Seventy-seven eyes of 77 patients(23,33 and 18 eyes,respectively) were included. Between groups, no significant difference was found in preoperative BCVA(0.81±0.36, 1.00±0.57, 0.92±0.58, respectively) and postoperative BCVA(0.19±0.35, 0.33±0.40, 0.22±0.17). There was an increase in BCVA in the postoperative 3rd year, and reduction in postoperative spherical error(p=0.04, p=0.03, p=0.03). No significant difference was found in vector analysis(0.57±0.49, 0.60±0.57, 0.58±0.52)(p=0.97). Groups had similar postoperative IOL tilt(3.30±3.27, 2.60±2.47, 1.40±1.21)(p=0.37) and decentralization(p=0.23).A positive correlation was found between vectorial astigmatism and IOL tilt(p=0.02 r=0.39) and between IOL tilt and cylindrical error(p=0.001 r=0.56).
Conclusions
In Marfan syndrome-associated crystalline lens dislocation, all three surgical techniques demonstrate favourable long-term visual outcomes and achieve effective intraocular lens stability.