PMID- 20466427
OWN - NLM
STAT- MEDLINE
DCOM- 20100826
LR  - 20100804
IS  - 1549-4713 (Electronic)
IS  - 0161-6420 (Linking)
VI  - 117
IP  - 8
DP  - 2010 Aug
TI  - Outcomes of iris-claw anterior chamber versus iris-fixated foldable intraocular 
      lens in subluxated lens secondary to Marfan syndrome.
PG  - 1479-85
LID - 10.1016/j.ophtha.2009.12.043 [doi]
AB  - PURPOSE: To compare the outcome of phacoemulsification using 2 different 
      iris-fixation techniques for intraocular lens (IOL) replacement, a foldable 
      posterior chamber IOL (PCIOL; AcrySof MA60AC, Alcon Laboratories Inc, Fort Worth, 
      TX) and an iris-claw anterior chamber IOL (ACIOL; Artisan, Ophtec BV), for 
      treatment of subluxated lenses in patients with Marfan syndrome (MFS). DESIGN: 
      Randomized, controlled trial. PARTICIPANTS: A total of 31 eyes of 16 patients 
      with subluxated lenses associated with MFS and a preoperative corrected visual 
      acuity (CVA) < or =20/40 based on the Early Treatment Diabetic Retinopathy Study 
      chart. METHODS: Patients were enrolled and the eye with worse visual acuity was 
      randomly assigned to 1 of 2 study arms: phacoemulsification and iris-fixated 
      PCIOL or phacoemulsification and iris-claw ACIOL; the second eye of the same 
      patient received the other IOL type. Preoperative and postoperative 
      ophthalmologic examination, optical coherence tomography, and endothelial cell 
      counts were performed. MAIN OUTCOME MEASURES: We recorded CVA results at 3, 6, 
      and 12 months, complications, endothelial cell loss, and central retinal 
      thickness. RESULTS: In the iris-fixated PCIOL group, CVA was significantly 
      improved at 3 (P = 0.011; n = 16), 6 (P = 0.006; n = 16), and 12 months (P = 
      0.002; n = 16). In the iris-claw ACIOL group, CVA was significantly improved at 3 
      (P = 0.001; n=15), 6 (P = 0.001; n = 15), and 12 months (P = 0.009; n = 12). The 
      CVA results did not differ significantly between groups. Dislocation of the IOL 
      occurred in 3 of 16 (18.75%) eyes in the PCIOL group. Retinal detachment occurred 
      in 3 eyes (2 in the PCIOL group and 1 in the ACIOL group) and was successfully 
      repaired. Postoperative foveal tomograms in both groups revealed a decrease in 
      the mean foveal thickness (MFT; < or =172 microm) in 54.16% of the patients. 
      CONCLUSIONS: The iris-sutured PCIOL and iris-claw ACIOL produced comparable 
      improvements in CVA at 3, 6, and 12 months postoperatively. Although IOL 
      dislocation tended to occur more frequently in the iris-fixated PCIOL group, the 
      difference was not significant. At 6 months postoperatively, all study patients 
      tended to have a thinner MFT. None of the patients in either group developed 
      cystoid macular edema.
CI  - Copyright 2010 American Academy of Ophthalmology. Published by Elsevier Inc. All 
      rights reserved.
FAU - Hirashima, Denise E
AU  - Hirashima DE
AD  - Federal University of Sao Paulo, Sao Paulo, Brazil. dehirashima@me.com
FAU - Soriano, Eduardo S
AU  - Soriano ES
FAU - Meirelles, Rodrigo L
AU  - Meirelles RL
FAU - Alberti, Gustave N
AU  - Alberti GN
FAU - Nose, Walton
AU  - Nose W
LA  - eng
PT  - Comparative Study
PT  - Journal Article
PT  - Randomized Controlled Trial
DEP - 20100513
PL  - United States
TA  - Ophthalmology
JT  - Ophthalmology
JID - 7802443
SB  - IM
MH  - Adolescent
MH  - Adult
MH  - Anterior Chamber/*surgery
MH  - Biometry
MH  - Female
MH  - Humans
MH  - Intraoperative Complications
MH  - Iridectomy
MH  - Iris/*surgery
MH  - Lens Implantation, Intraocular/*methods
MH  - Lens Subluxation/etiology/*surgery
MH  - *Lenses, Intraocular
MH  - Male
MH  - Marfan Syndrome/*complications
MH  - *Phacoemulsification
MH  - Postoperative Complications
MH  - Treatment Outcome
MH  - Visual Acuity/physiology
MH  - Vitrectomy
MH  - Young Adult
EDAT- 2010/05/15 06:00
MHDA- 2010/08/27 06:00
CRDT- 2010/05/15 06:00
PHST- 2009/04/04 00:00 [received]
PHST- 2009/12/24 00:00 [revised]
PHST- 2009/12/29 00:00 [accepted]
PHST- 2010/05/15 06:00 [entrez]
PHST- 2010/05/15 06:00 [pubmed]
PHST- 2010/08/27 06:00 [medline]
AID - S0161-6420(09)01530-9 [pii]
AID - 10.1016/j.ophtha.2009.12.043 [doi]
PST - ppublish
SO  - Ophthalmology. 2010 Aug;117(8):1479-85. doi: 10.1016/j.ophtha.2009.12.043. Epub 
      2010 May 13.