Bilateral clear lens extraction and intraocular lens implantation in a child with
            microspherophakia and Marfan syndrome

Farat, Joyce Godoy; Queiroz, Marjorie Fornazier Nascimento; Rodrigues, Antônio Carlos Lottelli

doi:10.5935/0004-2749.20190012

Cited by 6 publications

(3 citation statements)

References 8 publications

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“…The pressure of the lens haptics ovalized the capsular bag. [ 21 ] Earlier reports advised lensectomy for microspherophakia, based on worries concerning the uncertainty of the IOL position derived from the weakness of the zonules. [ 22 ] We choose technology to incarcerate the IOL optic region by anterior capsule opening, which played an important role in keeping the IOL steadily centered 1 month after operation.…”

Section: Discussionmentioning

confidence: 99%

Visual quality observation of clear lens extraction by ultrasonic phacoemulsification and intraocular lens implantation in a child with microspherophakia

Liu

Wang²,

Zhang³

2020

Medicine

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Rationale: Microspherophakia is characterized by a small, spherical crystalline lens with increased sagittal diameter. Because of the uncertainty about the outcome, as well as the complexity of the operation and development of complications, the management and timing of surgical intervention for microspherophakia are still debated. Lens extraction is effective for avoiding the risk of pupillary blockage, but the outcome after operation is controversial. The iTrace (Tracey, USA) report shows the influence of low-order aberrations (LOA) and high-order aberrations (HOA), which may be valuable in predicting postoperative outcome. Our report concerns a child with microspherophakia who underwent lens extraction via the analysis of visual quality by iTrace. Patient concerns: Our report is on the case of a 7-year-old girl whose parents observed she had to bring her papers and books extremely close to her face to read. On examination, the girl was bilaterally diagnosed microspherophakia with a small tremble lens. The objective refraction was −15.0 diopter of spherical power (DS)/−1.00 diopter of cylindrical power (DC) × 180 right eye (OD) and −12.5 DS/−1.50 DC × 20 left eye (OS). The HOA of OD and OS were high up to 0.926 and 0.659, respectively by iTrace. The visual quality remained terrible after correcting LOA (high myopia and astigmatism). According to iTrace report, the patient would get a good visual quality by extracting the clear lens with HOA from cornea after correcting LOA. The girl's parent opted for surgery on the left eye. Diagnosis: Due to the patient's symptoms, examination results, she was diagnosed with microspherophakia. Interventions: The patient underwent clear lens extraction by ultrasonic phacoemulsification and intraocular lens implantation. Outcomes: The first day after operation, total HOA was decreased to 0.077. Total LOA was 0.713. Corrected distance visual acuity (CDVA) is 20/20. One week after surgery, HOA was 0.110 and LOA was 0.328. CDVA was 20/25. CDVA was still 20/25 one month after surgery. The total HOA was 0.110 and the LOA was 0.334 by iTrace. Lessons: ITrace not only plays an important role in analyzing potential reasons of undesirable preoperative visual quality but also can predict postoperative outcomes. All these functions are helpful for determining surgical intervention of microspherophakia cases.

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Section: Discussionmentioning

confidence: 99%

Visual quality observation of clear lens extraction by ultrasonic phacoemulsification and intraocular lens implantation in a child with microspherophakia

Liu

Wang²,

Zhang³

2020

Medicine

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“…Therefore, the selection of IOL power deserves more careful consideration in those patients to achieve the refractive target. Microspherophakia and megalocornea are sometimes found in eyes of MFS patients [34, 35]. To the best of our knowledge, the prevalence of these 2 comorbidities in MFS patients with bilateral EL has never been reported.…”

Section: Discussionmentioning

confidence: 99%

Analysis of Axial Length in Young Patients with Marfan Syndrome and Bilateral Ectopia Lentis by Z-Scores

Chen

Zhang

et al. 2021

Ophthalmic Res

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Introduction: Marfan syndrome (MFS) is characterized by ectopia lentis (EL) and elongated axial length (AL). The characteristics of AL in young patients with MFS and bilateral EL before the lens surgery are not fully understood. Methods: This study reviewed MFS patients under 20 years old with bilateral EL from January 2015 to October 2020. The Z-scores were introduced in terms of the number of standard deviations from the mean of age-matched normative data. Using Z-scores, the distribution of AL and influence factors were evaluated. The correlations between AL and other biometrics were analyzed. Results: We reviewed 183 patients and enrolled both eyes. The mean age was 8.44 ± 4.69 years. About 36% of the patients were children under 6 years old. The median AL increased from 23.16 mm under 5 years old to 26.20 mm in the 16–20 age group, and when plotted, the trend presented a logarithmic curvature (R2 = 0.145, p < 0.001). The median Z-AL score was 1.24. One-third of eyes had Z-score <0. About 20% of the patients had AL difference over 1 mm between the right and left eyes, and the right one had longer Z-AL scores (p = 0.013). The eye complicated with megalocornea (10, 7.04%) had larger Z-AL scores (4.72 ± 3.51 vs. 1.10 ± 2.25, p = 0.002). A positive correlation was found between Z-AL and Z-corneal curvature radius (r = 0.265, p < 0.001). Conclusion: Young patients with bilateral EL but small AL should not be excluded from MFS without systematic examination. The age-adjusted Z-score will facilitate further study of the individual variations in AL across different ages.

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“…Therefore, the selection of IOL power deserves more careful consideration in those patients in order to achieve the refractive target. Microspherophakia and megalocornea are sometimes found in eyes of MFS patients 33,34 . To the best of our knowledge, the prevalence of these two comorbidities in MFS patients with bilateral EL have never been reported.…”

Section: Discussionmentioning

confidence: 99%

Analysis of axial Length of Marfan Syndrome with Bilateral Ectopia Lentis by Z-scores for Chinese Patients under 20 years Old

Chen¹,

Chen²,

Zhang³

et al. 2020

Preprint

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Purpose: To analyze the axial length (AL) in young patients with Marfan syndrome (MFS) and bilateral ectopia lentis (EL) before the lens surgery. Methods: This study reviewed MFS patients under 20 with bilateral EL from January 2015 to October 2020. The Z-scores were introduced in terms of the number of standard deviations (SD) from the mean of age-matched normative data. Using Z-scores, the distribution of AL and influence factors were evaluated. The correlations between AL and other biometrics were analyzed. Results: We reviewed 183 patients, and enrolled both eyes. The mean age was 8.44 ± 4.69 years old. The mean AL increased from 23.41 ± 1.73 mm under 5 years old to 26.40 ± 2.28 mm in the 16-20 age group, and when plotted, the trend presented a logarithmic curvature. The mean Z-AL score was 1.74 ± 2.68. One-third of eyes had Z-score < 0. The right eye and the eye complicated with megalocornea had larger Z-AL scores. A positive correlation was found between Z-AL and Z-Corneal Curvature Radius (r = 0.265, P < 0.001).Conclusion: Young patents with bilateral EL but small AL should not be excluded from MFS without systematic examination. The age-adjusted Z-score will facilitate further study of the individual variations in AL across different ages.

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Bilateral clear lens extraction and intraocular lens implantation in a child with microspherophakia and Marfan syndrome

Cited by 6 publications

References 8 publications

Visual quality observation of clear lens extraction by ultrasonic phacoemulsification and intraocular lens implantation in a child with microspherophakia

Visual quality observation of clear lens extraction by ultrasonic phacoemulsification and intraocular lens implantation in a child with microspherophakia

Analysis of Axial Length in Young Patients with Marfan Syndrome and Bilateral Ectopia Lentis by Z-Scores

Analysis of axial Length of Marfan Syndrome with Bilateral Ectopia Lentis by Z-scores for Chinese Patients under 20 years Old

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