Visual Outcomes after Lensectomy and Iris Claw Artisan intraocular Lens Implantation in Patients with Marfan syndrome

To report clinical outcomes of crystalline lens extraction and iris claw Artisan intraocular lens (IOL) implantation in patients with lens subluxation secondary to Marfan syndrome.
This retrospective study enrolled 14 eyes of 12 Marfan patients with lens subluxation who underwent crystalline lens removal and Artisan IOL implantation. Pre- and post-operative data, including patient demographics, pre and post-operative comorbidities and complications were compiled. Measured outcomes were visual acuity and occurrence of complications. Uncorrected visual acuity (UCVA), best-corrected visual acuity (BCVA) and spherical equivalent (SE) refraction were compared before and after lens extraction and IOL insertion.
The mean patient age was 30.03 ± 15.02 years and the mean post-operative follow-up duration was 44.5 ±16.4 months. The mean BCVA showed a significant improvement from 0.5 ± 0.3 at the baseline to 0.2 ± 0.2 postoperatively (P=0.006). SE refraction significantly decreased from -11.38 ± 1.99 D preoperatively to -0.45 ± 1.65 D postoperatively (P=0.003). The IOL position was desirable in all eyes except one which had IOL dislocation. One eye developed retinal detachment. No other complication such as ocular hypertension, angle abnormalities, clinical cystoids macular edema, or corneal decompensation was observed during the follow-up period.
Artisan IOL implantation after lens extraction appeared to be an appropriate alternative for optical correction in cases of Marfan syndrome with ectopia lentis. It resulted in a significant improvement in visual acuity with an acceptable complication profile.