PARS-PLANA VITRECTOMY, LENSECTOMY, OR EXTRACTION IN TRANSSCLERAL INTRAOCULAR-LENS FIXATION FOR THE MANAGEMENT OF DISLOCATED LENSES IN A FAMILY WITH MARFANS-SYNDROME

BACKGROUND AND OBJECTIVES: Congenital lens subluxation may be a diffic ult therapeutic problem. Surgical treatment options include iris manip ulation or lens discission, aspiration, intracapsular or extracapsular extraction, and lensectomy through the pars plana. It is not establis hed which kind of aphakic correction is the most appropriate in these cases. PATIENTS AND METHODS: A father and his two sons with Marfan's s yndrome were operatively treated for lens dislocation in both eyes. Pa rs plana vitrectomy was done in all eyes. Dislocated lenses were remov ed by lensectomy in three eyes and with an intracapsular method in thr ee eyes. The outside-in scleral fixation technique was used for primar y posterior chamber intraocular lens (PC IOL) implantation in all case s. RESULTS: All eyes achieved good visual acuity (20/20-20/25). Time o f observation ranged between 8 and 20 months. There were no intraopera tive or postoperative complications CONCLUSION: Pars plana vitrectomy and primary scleral-fixated IOL implantation is a safe procedure and g ives good visual rehabilitation in adult patients with Marfan's syndro me.