SURGERY OF MARFAN-ASSOCIATED AND IDIOPATH IC LENS SUBLUXATIONS

Background: The ideal and safe surgical method for Marfan-associated o r idiopathic lens subluxations is still a matter of debate. Patients a nd methods: Between 1990 and 1995, 23 eyes were operated for lens subl uxations, mainly because of decreased visual acuity, but also because of conservatively uncontrolled secondary glaucoma. Marfan patients wer e 27.0 (5-62) years old at surgery; patients with idiopathic lens subl uxations were 38.5 (11-63) years old. Surgical procedure depended on p atient age and anatomical conditions. Results: All patients achieved a n increase in visual acuity. Amblyopia existed in six patients. All pr oblems due to glaucoma were controlled postoperatively. Our greatest c oncern was rhegmatogenous retinal detachment. It occurred in only one eye of a non-Marfan patient. C onclusion: The prognosis for lens surge ry in Marfan-associated and idiopathic lens subluxations is good. The implantation of a posterior chamber lens provides a goad and secure me ans of optical rehabilitation. Our preferred primary transscleral sutu re technique guarantees high security and stability of position. Previ ously feared surgical risks have been reduced by modern surgical proce dures.