Management of the Subluxed Crystalline Lens

Monoscleral fixation of IOL after extracapsular extraction of subluxated lenses in patients with Marfan syndrome

“…Various techniques have already been discussed for the purpose of reducing complications and improving surgical results (4,(6)(7)(8)(9)(10)(11)(12) . The procedures most commonly used today are phacoemulsification and limbal or pars plana lensectomy, with or without IOL implantation (6)(7)(8)(9)(13)(14) .…”

“…The procedures most commonly used today are phacoemulsification and limbal or pars plana lensectomy, with or without IOL implantation (6)(7)(8)(9)(13)(14) . Other studies (7,14) reported good results and few complications for nontraumatic subluxations using limbal and pars plana lensectomy (7) without IOL implant. To avoid aphakia, there are some options with similar results: after lensectomy and anterior vitrectomy, anterior chamber lens can be used (6) .…”

“…Although several studies (6)(7)9,11,(13)(14) have shown good results with techniques other than extracapsular cataract extraction associated with the scleral fixation of IOL in the ciliary sulcus, this can be considered a surgical option for cases of ectopia lentis associated with Marfan syndrome, and probably it can be used in subluxations of other etiologies (however other studies are required to evaluate this idea) where there are zonular and capsular supports for the IOL, and apart from very good surgical results and few complications, it is easy to perform.…”

“…Other ocular features include: astigmatism, axial myopia, flat cornea, glaucoma (due to incomplete development of angle structures), and retinal detachment (due to myopia and aphakia) (4)(5) . Various surgical techniques have been described for the treatment of ectopia lentis, among these are the following: sectorial iridectomy, intra-and extracapsular extraction of the lens, phacoemulsification, and limbal or pars plana lensectomy (4,(6)(7)(8)(9)(10)(11)(12) . However, there is still no consensus about which technique is the safest and most effective in these cases, especially in some countries or regions where automated equipment is scarce and phacoemulsification is not available.…”

Phacoemulsification using iris hooks and scleral fixation of the intraocular lens in patients with secondary glaucoma associated with lens subluxation

“…[6][7][8][9] Pars plana lensectomy (PPL) has provided good surgical outcomes, and is regarded as the standard surgical modality for the treatment of secondary glaucoma associated with lens dislocation. 9 However, in some cases of lens subluxation and mild dislocation, pars plana vitrectomy seemed excessive.…”