12/09/2024
Inferotemporally dislocated crystalline lens in a 25 year old male with Marfans Syndrome. This inherited condition affects connective tissue, resulting in weakened blood vessels, heart, eyes and bones.
The lens was gradually slipping out of place over the years and best corrected vision had declined to 20/80 with a contact lens. The other eye has no light perception vision since infancy, so numerous surgeons were hesitant to recommend surgery, which is reasonable. However since the patient was no longer able to function at work, he was eager for a treatment.
I performed pars plana vitrectomy, lensectomy and 360 barrier retinal laser to prevent retinal detachment. He is aphakic but doing well with his contact lens, which he is used to wearing for many years. I avoided placing an anterior chamber intraocular lens (ACIOL) because he is young and this increases risk of corneal decompensation over time. Also an ACIOL could worsen his glaucoma. I also avoided a scleral fixated IOL because Marfans patients have abnormally thin sclera.