Corneal Topography And Aberrometric Outcomes After Early Lensectomy With Retropupillary Iris-Claw Iol Implantation In Marfan Syndrome
Published 2026 - 44th Congress of the ESCRS
Reference: PP15.018 | Type: Free paper | DOI: 10.82333/zdkg-ej93
Authors: Prof. Dr Luis Izquierdo Jr* 1 , Alessandra Cano 2 , Claudia Pomatanta 2 , Rolando Rojas 2 , Dr Maria A. Henriquez 3
1Research department,Oftalmosalud Institute of Eyes,Lima,Peru;San Fernando School of Medicine,Universidad Nacional Mayor de San Marcos,Lima,Peru, 2Research department,Oftalmosalud Institute of Eyes,Lima,Peru, 3Oftalmosalud Institute of Eyes,Lima,Peru
Purpose
To evaluate visual, refractive, and aberrometric outcomes after early lensectomy with retropupillary iris-claw intraocular lens (IOL) implantation in patients with Marfan syndrome (MFS) and ectopia lentis.
Setting
Instituto de Ojos, OftalmoSalud, Lima, Perú.
Methods
A retrospective interventional case series included 58 eyes from 34 patients with MFS, diagnosed according to the revised Ghent-2 criteria. All eyes underwent pars plana lensectomy with anterior vitrectomy followed by retropupillary iris-claw IOL implantation. Visual acuity, refractive outcomes, and corneal, internal, and total ocular aberrations were analyzed preoperatively and postoperatively using Scheimpflug tomography (Pentacam HR). Complete aberrometric measurements were available in 16 eyes. Pre- and postoperative outcomes were compared using paired statistical analysis
Results
Mean uncorrected distance visual acuity improved from 1.24 ± 0.51 logMAR to 0.50 ± 0.29 logMAR (p < 0.001), and corrected distance visual acuity improved from 0.66 ± 0.38 logMAR to 0.23 ± 0.14 logMAR (p < 0.001). Spherical refraction and spherical equivalent were significantly reduced (p = 0.017 and p = 0.019, respectively), while cylindrical refraction showed no significant change. Corneal aberrations showed selective postoperative improvement, with significant reductions in tilt, coma, and trefoil. Internal and total ocular aberrations demonstrated marked and highly significant postoperative reductions across all parameters, including RMS, higher-order aberrations, tilt, coma, trefoil, and spherical aberration (all p < 0.001).
Conclusions
Early lensectomy with retropupillary iris-claw IOL implantation in MFS results in significant visual and refractive improvement and produces a profound reduction in internal and total ocular aberrations. These findings suggest that early surgical intervention restores optical quality and may optimize long-term visual prognosis in patients with ectopia lentis.