Lens surgery in Marfan's syndrome.

Management of the subluxed lens in Marfan’s syndrome presents one of the most challenging situations in contemporary lens surgery. Conventional approaches have included intracapsular lens extraction or a pars plana lensectomy with vitrectomy. Once the lens was removed, aphakia was corrected by glasses, contact lenses or an iris or angle supported anterior chamber IOL or a scleral sutured posterior chamber IOL. Marfan’s syndrome patients are known to have an increased risk of glaucoma as well as retinal detachment (upto 11 % of patients with Marfan syndrome, and 8–38 % in those who have dislocation of the lens or have undergone lens surgery) . Accordingly, anterior chamber implants are best avoided in this setting and a surgical approach which preserves the capsular bag and avoids disruption of the vitreous, will, at least potentially, reduce the risk of retinal detachment subsequently.