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Br J Ophthalmol. 2014 Oct;98(10):1338-42. doi: 10.1136/bjophthalmol-2013-304144. Epub 2014 May 15.

Risk factors for postoperative complications in lensectomy-vitrectomy with or without intraocular lens placement in ectopia lentis associated with Marfan syndrome.

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  • 1Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai, China.



To analyse the surgical outcomes and postoperative complications of 23-G lensectomy-vitrectomy in the management of ectopia lentis in patients with Marfan syndrome.


This retrospective study evaluated all patients with Marfan syndrome who received 23-G lensectomy-vitrectomy either through pars plana or the limbus for management of ectopia lentis between 1 January 2008 and 31 December 2011 at Eye and ENT Hospital of Fudan University.


A total of 64 eyes of 39 patients with Marfan syndrome (28 males and 11 females) underwent lensectomy-vitrectomy as a primary procedure for ectopia lentis. The best-corrected visual acuity improved significantly from 0.5 (0.3-0.7) LogMar preoperatively to 0.3 (0.1-0.5) LogMar (p<0.01) at the last postoperative visit. Retinal detachment (RD) occurred in 11 eyes. Comparing the characteristics between those patients with detached and non-detached retinas, a more severe grade of lens dislocation (p=0.001) and higher axial myopia (p=0.035) were observed among those with detached retinas, whereas there were no significant differences between the two groups in terms of age (p=0.624), pseudophakia or aphakia (p=0.672), and preventive photocoagulated breaks (p=0.719). There was no significant difference in the incidence of RD between the scleral-fixated intraocular lens group and anterior chamber intraocular lens group (p=0.412).


Development of RD in patients with Marfan syndrome remains a risk following surgery for ectopia lentis. Caution should be taken in eyes with severe lens dislocation or high axial myopia when planning the surgery.

Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to


Marfan syndrome; ectopia lentis; limbal approach; pars plana approach; retinal detachment

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