Management of ectopia lentis in a family with Marfan syndrome
S. B. Koenig and W. F. Mieler
Department of Ophthalmology, Eye Institute, Medical College of Wisconsin, Milwaukee.
OBJECTIVE: To determine the effectiveness of combined pars plana
vitrectomy-lensectomy and open-loop anterior chamber lens implantation for
the management of ectopia lentis associated with Marfan syndrome. METHODS:
Retrospective review of the medical records of 4 consecutive patients with
Marfan syndrome who underwent combined pars plana lensectomy-vitrectomy and
anterior chamber lens implantation at our institution between August 1994
and July 1995. RESULTS: All patients demonstrated postoperative visual
acuity of 20/25 or better during an average follow-up period of 6 months
(range, 4-9 months). Two patients developed pseudophakic pupillary block
and required YAG laser iridotomy postoperatively. CONCLUSIONS: Pars plana
lensectomy-vitrectomy and anterior chamber intraocular lens implantation
appears to be an excellent technique for the management of ectopia lentis
associated with Marfan syndrome. A bimanual, closed-system endosurgical
technique avoids many of the complications previously associated with
surgery for ectopia lentis.
