Surgical Treatment of Lens Subluxation in Marfan Syndrome: Cionni Ring Insertion Versus Scleral Fixation of Foldable IOLs Over Preserved Bag
Purpose
To compare two surgical techniques for the management of hereditary lens subluxation regarding the operative difficulty and complications and the visual outcome.
Methods
this study is a prospective randomized comparative study including 36 eyes with hereditary lens subluxation seeking for surgical refractive solution after incompliance with non surgical methods (glasses and contact lenses). They are divided into 2 groups , group a treated by phacoaspiration, insertion of sclerally fixated Cionni ring then in the bag foldable IOL implantation. Group B included 18 eyes which are treated by phacoaspiration and scleral fixation of foldable IOL over the preserved bag and zonules.
Results
A total of 36 eyes of 22 patients were included. Mean postoperative follow-up was 2.2 ± 1.3 years (range, 1-3 years). Average age at surgery was 8.2 ± 5.4 years (range, 5-16 years). The average preoperative best-corrected visual acuity was 20/80 in group A and 20/25 in group B. No statically difference between the 2 group regarding the postoperative visual outcome. Both groups showed few intraoperative complications as zonular injury, hyphema and vitreous prolapse. Postoperative complications as PCO occurred in most patient but only patients of group A needed Yag capsulotomy.
Conclusion
Both methods of surgical management of hereditary lens subluxation showed comparable postoperative visual improvement with few intra and postoperative complications.