[Surgical management of Marfan-associated and idiopathic lens dislocations].

BACKGROUND

The ideal and safe surgical method for Marfan-associated or idiopathic lens subluxations is still a matter of debate.

PATIENTS AND

METHODS

Between 1990 and 1995, 23 eyes were operated for lens subluxations, mainly because of decreased visual acuity, but also because of conservatively uncontrolled secondary glaucoma. Marfan patients were 27.0 (5-62) years old at surgery; patients with idiopathic lens subluxations were 38.5 (11-63) years old. Surgical procedure depended on patient age and anatomical conditions.

RESULTS

All patients achieved an increase in visual acuity. Amblyopia existed in six patients. All problems due to glaucoma were controlled postoperatively. Our greatest concern was rhegmatogenous retinal detachment. It occurred in only one eye of a non-Marfan patient.

CONCLUSION

The prognosis for lens surgery in Martan-associated and idiopathic lens subluxations is good. The implantation of a posterior chamber lens provides a good and secure means of optical rehabilitation. Our preferred primary transscleral suture technique guarantees high security and stability of position. Previously feared surgical risks have been reduced by modern surgical procedures.