Surgery with the use of iris retractors for subluxation of lens in Marfan syndrome

Objective To evaluate the clinical efficiency of the application of iris retractors for the treatment of subluxation of lens in patients with Marfan’s syndrome. Methods This study comprised 20 eyes of 12 patients with Marfan’s syndrome and subluxation of lens. The ranges of lens subluxation were all more than 180 degrees. After continuous curvilinear capsulorrhexis, 2-3 iris retractors were used to drag and fixate the edge of capsulorhexis opening. Following phacoemulsification and aspiration, the residual lens capsular bag was removed. Anterior vitreous resection was performed if vitreous prolapsed after removal of the capsular bag. Finally, the intraocular lens (IOL) was sutured and fixated at the ciliary sulcus. The visual acuity, the position of IOLs and surgical complications were observed for 6-12 months. Results All the 20 eyes of 12 cases underwent successful surgery. Six months after surgery, the best corrected visual acuity was at 0.3-0.6 in 14 eyes (70.00%) and more than 0.8 in 6 eyes (30.00%). Postoperative visual acuity significantly improved compared with preoperative visual acuity (finger counting-0.2) (Z=-5.44, P=0.00). The IOLs were well centered in all cases during follow-up. No severe complication such as retinal detachment, macular edema or corneal endothelium decompensation was observed. Conclusion Application of iris retractors for patients of Marfan’s syndrome with subluxation lens can provide excellent intraoperative capsular stability and facilitate the manipulation during operation. Key words: Iris retractor; Marfan’s syndrome; Subluxation of lens; Phacoemulsification