The management of ocular complications of Marfan's syndrome, especially ectopia lentis, is challenging. In this study, we present the effectiveness and the safety of iris-claw intraocular lens (IOL) implantation along with lensectomy for those patients. Also, we compare the practice of implanting these IOLs either in the anterior chamber of retropupillary. Methods: Retrospectively, we included all patients with Marfan's syndrome who underwent lensectomy with iris-claw IOL implantation as a result of ectopia lentis. The patients were categorized into two groups: anterior chamber iris claw IOL and retropupillary iris-claw IOL. The clinical and demographic data, the visual outcome and postoperative complications were compared. Results: Eighteen eyes of 10 patients were included in the study. The mean age of the patients was 19.1 years. Six patients were males. The iris-claw IOL was implanted anteriorly in 13 eyes. The visual outcome was comparable between both groups and most patients achieved improvement in the visual acuity. In addition, the postoperative complications developed similarly in both groups. However, all cases of IOL disenclavation (6 cases) developed in the anterior group. It is revealed that the age of the patient was the most significant factor affecting the occurrence of IOL disenclavation. Conclusion: Iris-claw IOL (either anteriorly or retropupillary) is an effective and relatively safe method in treating ectopia lentis in patients with Marfan's syndrome. In younger patients, anterior iris-claw IOL is safer than retropupillary iris-claw IOL as the risk of disenclavation is higher in younger patients.
Aim: We report a rare case of postoperative endophthalmitis caused by Escherichia coli. Case description: The diagnosis of postoperative endophthalmitis in our patient was established based on the clinical signs of hypopyon along with vitritis. The patient underwent pars plana vitrectomy, anterior chamber washout, intraocular lens removal, and intravitreal antibiotics (amikacin and vancomycin) injection. The culture of both the vitreous sample and the intraocular lens, revealed a heavy growth of Escherichia coli. Conclusion: Escherichia coli is an unusual microorganism to cause postoperative endophthalmitis. A major breach in the sterilization may explain this infection. Proper sterilization and prophylactic measures are crucial to avoid this disastrous complication.
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