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Beatrice E Frueh, Dagmar Steinmair, Christop Tappeiner, Dan Epstein; Results of sulcus-fixated IOLs in Marfan children with subluxated lenses. Invest. Ophthalmol. Vis. Sci. 2018;59(9):2205.
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© ARVO (1962-2015); The Authors (2016-present)
To report the results of sulcus-fixated IOLs in Marfan children with subluxated lenses.
We performed a retrospective case review of all Marfan children with subluxated lenses who underwent surgery between 2012 and 2016 by one surgeon (BEF) at our tertiary center. Inclusion criteria were a minimum follow-up of 1 year and age ≤10 years. The same surgical approach was used in every case (phakoemulsification, iris hooks in the capsular bag, anterior vitrectomy and sulcus-fixation of a 7 mm PMMA IOL). Primary outcome measures were BCVA for near and distance, refractive cylinder, spherical equivalent (SE), and complications.
20 eyes of 12 children were included. Mean age was 5.2±1.9 years (3-10 years), mean follow-up was 33.7±12.7 months ( 12-58 months). No intraoperative complications occurred. Postoperative complications included one haptic dislocation at 2 weeks needing refixation, one pupillary block at day 1, and one case of high astigmatism managed by suture removal at 2 months. SE improved significantly from -6.3±4.1D before surgery to 0.4±1.4D at 1 year, -0.4±1.2D at 2 years, and -2.0±1.0D at 3 years. The refractive cylinder showed a high astigmatism prior to surgery (-6.1±3.4D). it decreased to -1.7±1.8D at 1 year, -2±1.3D at 2 years and -2.3±1.2D at 3 years. There was not a single case of lost lines. BCVA at near (LogMar) was 0.7±0.2 preoperatively, 0.2±0.2 at 1 year, 0.2±0.2 at 2 years, and 0.1±0.2 at 3 years. BCVA at distance (LogMar) also improved from 0.5±0.2 to 0.1±01 at 1 year, 0.1±0.1 at 2 years, and 0.05±0.07 at 3 years.
Although the management of subluxated lenses in children is still controversial, our data show that sulcus-fixation of IOLs in Marfan children is safe and results in excellent visual acuity. To the best of our knowledge, this is the longest follow-up reported with this technique in such patients.
This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.
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