Intrascleral four-flanged intraocular lens fixation technique for lens dislocation with Marfan syndrome

Purpose: To observe the clinical efficacy of intrascleral four-flanged intraocular lens(IOL) fixation technique for lens dislocation with Marfan syndrome. Methods A retrospective analysis Observed twelve patients with Marfan syndrome(15 eyes) with lens dislocation who had underwent this operation(A 30g needle was used to puncture into the eye at 2, 4 o'clock or 8, 10 o'clock from the outside of the eye, respectively,.Both ends of the 7 − 0 polypropylene thread were guided through the two eyelets on the ipsilateral side of the Akreos AO IOL and out of the eyeball,and then the two ends of the suture were borned to form flanges. Finally two pairs (four) flanges are formed at 2,4 o'clock and 8,10 o'clock, which were riveted within the scleral tunnel, so as to fix the IOL). Corrected distance visual acuity(CDVA), intraocular pressure(IOP), tilt and decentration of the IOL and postoperative complications were evaluated. Results All operations were completed successfully. The CDVA prior to the fixation surgery was 3.36 ± 0.886 logMAR and on the first day aftet the surgery was 4.12 ± 0.928 logMAR. The CDVA was significantly improved following surgery (t = 0.660, p = 0.029). The CDVA on the last visit was 4.48 ± 0.736 logMAR, Compared with the first day after surgery, the difference is not statistically significant (t = 0.332, p = 0.249). No intraoperative complications were reported. Postoperatively, elevated IOP 4h after surgery was recorded in 6 eyes (40.0%), cystoid macular edema (CME) was seen in 2 eyes (13.33%), vitreous hemorrhage and flange exposure were seen in one eye each, corneal edema and anterior chamber inflammation were seen in 4 eyes each. The IOLs were centered without tilt and decentration. Conclusions The intrascleral four-flanged IOL for lens dislocation with Marfan syndrome experienced a low incidence of complication with excellent visual outcome. This technique is a simple, effective, and safe method.