Phacoemulsification Combined With Supra-Capsular and Scleral-Fixated Intraocular Lens Implantation in Microspherophakia: A Retrospective Comparative Study

Abstract

BackgroundMicrospherophakia (MSP) is a rare ocular condition, the lens surgery of which is complicated by both insufficient zonules and undersized capsule.MethodsThis study included MSP eyes managed with phacoemulsification combined with supra-capsular and scleral-fixated intraocular lens implantation (SCSF-IOL) and made the comparison with those treated by transscleral-fixated modified capsular tension ring and in-the-bag intraocular lens implantation (MCTR-IOL).ResultsA total of 20 MSP patients underwent SCSF-IOL, and 17 patients received MCTR-IOL. The postoperative best corrected visual acuity was significantly improved in both groups (P < 0.001), but no difference was found between the groups (P = 0.326). The IOL tilt was also comparable (P = 0.216). Prophylactic Nd:YAG laser posterior capsulotomy was performed 1 week to 1 month after the SCSF-IOL procedure. In the SCSF-IOL group, two eyes (10.00%) needed repeated laser treatment and one eye (5.00%) had a decentered capsule opening. Posterior capsule opacification was the most common complication (6, 35.29%) in the MCTR group. No IOL dislocation, secondary glaucoma, or retinal detachment was observed during follow-up.ConclusionsSCSF-IOL is a viable option for managing MSP and is comparable with the MCTR-IOL. Nd:YAG laser posterior capsulotomy was necessary to prevent residual capsule complications after the SCSF-IOL procedure.

Genotype-phenotype correlations of marfan syndrome and related fibrillinopathies: Phenomenon and molecular relevance

“…As a special form of EL, microspherophakia is characterized by the globular laxity of the zonules and the lens growth of which is arrested by insufficient mechanical stretching ( Kumar et al, 2019 ). Microspherophakia was found in about 10% of patients with MFS and the surgical management of which is different from other types of EL ( Chen et al, 2021b ; Chen et al, 2022 ). Chen et al revealed that variants in exons 22–42, especially exon 26, had higher risks of combined microspherophakia in patients with MFS ( Chen et al, 2021c ).…”

Genotype Impacts Axial Length Growth in Pseudophakic Eyes of Marfan Syndrome

“…In cases where a peripheral extension or tearing of the capsulorhexis rim occurred, a single-piece foldable IOL was sutured to the sclera using double-strand 9–0 polypropylene (MANI Inc., Tochigi, Utsunomiya, Japan) after anterior lensectomy combined with capsulotomy (23G; Alcon Laboratories Inc., Fort Worth, TX, USA) through a limbal approach. 22 …”