Surgery technique for subluxation in Marfan syndrome
Reviewed by Fiona Rowe

The authors evaluated the efficacy and safety of bimanual capsulorrhexis combined with sutureless scleral-fixated IOL implant in children with Marfan syndrome. Seven children (14 eyes) with subluxated lenses underwent bilateral surgery; four female, three male with mean age of 7.1 years (4-12). All underwent surgery because of amblyopia related to refractive error. Mean pre- and postoperative uncorrected visual acuity was 1.47 ±0.41 and 0.42 ±0.15 logMAR respectively. Best corrected visual acuity was 0.81 ±0.30 and 0.20 ±0.11 logMAR respectively. Pre- and post-spherical equivalent refraction was -9.69 ±4.59 and -0.27 ±1.21D respectively. Surgery successfully provided an adequate capsular opening in all cases. There was a low rate of complications with these including anterior uveitis, hypotony, lens optic capture and retinal detachment. Average follow-up was 16.8 ±8.1 months. The IOL was well centred in all eyes at last follow-up examination. The authors discuss that their technique made it possible to avoid suture-related IOL dislocations and resultant complications but acknowledge future longer-term complications such as IOL drop could develop. They acknowledge their small sample size and potential complications from use of polypropylene haptics. However, they had good overall visual acuity results and low complication rates. They recommend further research with larger numbers and longer follow-up.

Sutureless scleral-fixated IOL implantation in the treatment of congenital lens subluxation related to Marfan syndrome.
Bulut MN, Goktas E, Karadag E, et al.
JOURNAL OF PEDIATRIC OPHTHALMOLOGY AND STRABISMUS
2021;58:401-6.