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Takahashi A, Arima T, Toda E, Kobayakawa S, Shimizu A, Takahashi H. A Novel Multi-Observation System to Study the Effects of Anterior Ocular Inflammation in Zinn’s Zonule Using One Specimen. Int J Mol Sci 2023; 24:ijms24076254. [PMID: 37047225 PMCID: PMC10093946 DOI: 10.3390/ijms24076254] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Revised: 03/24/2023] [Accepted: 03/24/2023] [Indexed: 03/29/2023] Open
Abstract
Zinn’s zonule is a fragile and thin tissue, and little is known about its pathogenesis. The aim of this study was to develop an experimental setup for a comprehensive analysis of Zinn’s zonule. Rats were divided into two groups: a control group (n = 4) and an alkali injury group (n = 4). Seven days after injury, the eyes were enucleated, the anterior eye was dissected and embedded in gelatin, and macroscopic observations were made. The gelatin specimens were then embedded in paraffin and observed in detail by low-vacuum scanning electron microscopy, immunofluorescence, and quantitative reverse transcription polymerase chain reaction (RT-qPCR). The results show qualitative changes in Zinn’s zonules in both macroscopic and microscopic observations. In addition, macrophage infiltration and increased matrix metalloproteinase 2 (MMP2) expression were observed in the injured group, consistent with the RT-qPCR results. The experimental system in this study allowed us to capture the morphological and molecular biological changes of Zinn’s zonule and to gain insight into its pathogenesis. In conclusion, this study presents a new experimental setup for the comprehensive analysis of the rat Zinn’s zonule. The results suggest that this system can be used in the future to study and analyze a variety of paraffin-embedded tissues and specimens.
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Affiliation(s)
- Akira Takahashi
- Department of Ophthalmology, Nippon Medical School, Tokyo 113-8602, Japan; (A.T.)
- Department of Analytic Human Pathology, Nippon Medical School, Tokyo 113-8602, Japan
| | - Takeshi Arima
- Department of Ophthalmology, Nippon Medical School, Tokyo 113-8602, Japan; (A.T.)
- Department of Analytic Human Pathology, Nippon Medical School, Tokyo 113-8602, Japan
- Correspondence:
| | - Etsuko Toda
- Department of Analytic Human Pathology, Nippon Medical School, Tokyo 113-8602, Japan
| | - Shinichiro Kobayakawa
- Department of Ophthalmology, Nippon Medical School, Musashikosugi Hospital, Kanagawa 211-8533, Japan
| | - Akira Shimizu
- Department of Analytic Human Pathology, Nippon Medical School, Tokyo 113-8602, Japan
| | - Hiroshi Takahashi
- Department of Ophthalmology, Nippon Medical School, Tokyo 113-8602, Japan; (A.T.)
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Bulut MN, Göktaş E, Karadağ E, Bulut K, Oral AY, Şimşek Ş. Sutureless Scleral-Fixated Intraocular Lens Implantation in the Treatment of Congenital Lens Subluxation Related to Marfan Syndrome. J Pediatr Ophthalmol Strabismus 2021; 58:401-406. [PMID: 34228568 DOI: 10.3928/01913913-20210428-02] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
PURPOSE To evaluate the efficacy and safety of bimanual capsulorhexis combined with sutureless scleral-fixated intraocular lens (IOL) implantation in children diagnosed as having Marfan syndrome. METHODS The study included 14 eyes with subluxated lenses of 7 children who were diagnosed as having Marfan syndrome and underwent bimanual capsulorhexis combined with sutureless scleral-fixated IOL implantation by the same surgeon between 2015 and 2019 at the University of Health Sciences, Kartal Dr. Lütfi Kirdar City Hospital's Eye Department. RESULTS The mean preoperative and postoperative uncorrected visual acuity was 1.47 ± 0.41 and 0.42 ± 0.15 logarithm of the minimum angle of resolution (logMAR), respectively (P = .001). The preoperative best corrected visual acuity (BCVA) ranged from 1.30 to 0.40 logMAR with a mean value of 0.81 ± 0.30 logMAR. Postoperatively, all patients had an increase in the BCVA with a mean value of 0.20 ± 0.11 logMAR, which was statistically significant (P = .001). The mean preoperative and postoperative spherical equivalent was -9.69 ± 4.59 and -0.27 ± 1.21 diopters, respectively. CONCLUSIONS Despite the small number of patients in this study, good visual results and a low complication rate were obtained in patients with ectopic lens. The long-term IOL status in patients who have undergone sutureless scleral-fixated IOL implantation will make it possible to better evaluate the safety and applicability of the technique. [J Pediatr Ophthalmol Strabismus. 2021;58(6):401-406.].
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Choi EY, Lee CH, Kang HG, Han JY, Byeon SH, Kim SS, Koh HJ, Kim M. Long-term surgical outcomes of primary retropupillary iris claw intraocular lens implantation for the treatment of intraocular lens dislocation. Sci Rep 2021; 11:726. [PMID: 33436860 PMCID: PMC7804091 DOI: 10.1038/s41598-020-80292-3] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2020] [Accepted: 11/09/2020] [Indexed: 11/16/2022] Open
Abstract
We aimed to investigate the efficacy and safety of primary retropupillary iris claw intraocular lens (R-IOL) implantation in patients with complete intraocular lens (IOL) dislocation. In this single-center retrospective case series, we reviewed the medical records of patients who underwent R-IOL implantation surgery with pars plana vitrectomy for the treatment of IOL dislocation between September 2014 and July 2019. The primary outcome was change in visual acuity (VA) up to 24 months postoperatively. The secondary outcomes included changes in intraocular pressure (IOP), refractive errors, and endothelial cell count (ECC) over the same period. Data of 103 eyes (98 patients) were analyzed. The mean uncorrected VA was significantly improved at one month postoperatively (− 0.69 logMAR, P < 0.001), compared to the preoperative value. IOP (− 2.3 mmHg, P = 0.008) and ECC (− 333.4 cells/mm2, P = 0.027) significantly decreased one month post-surgery and remained stable thereafter. Postoperative mean spherical equivalents were similar to the prediction error throughout the follow-up period. IOP elevation (n = 8, 7.8%), cystoid macular edema (n = 4, 3.9%), and dislocation of the R-IOL (n = 10, 9.7%) were managed successfully. Overall, primary R-IOL implantation with pars plana vitrectomy is effective and safe for correcting IOL dislocation due to various causes.
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Affiliation(s)
- Eun Young Choi
- Department of Ophthalmology, Institute of Vision Research, Severance Eye Hospital, Yonsei University College of Medicine, 50-1, Yonseiro, Seodaemun-gu, Seoul, 03722, Korea
| | - Chul Hee Lee
- Department of Ophthalmology, Institute of Vision Research, Gangnam Severance Hospital, Yonsei University College of Medicine, 211, Eonjuro, Gangnam-gu, Seoul, 06273, Korea
| | - Hyun Goo Kang
- Department of Ophthalmology, Institute of Vision Research, Gangnam Severance Hospital, Yonsei University College of Medicine, 211, Eonjuro, Gangnam-gu, Seoul, 06273, Korea
| | - Jae Yong Han
- Department of Ophthalmology, Institute of Vision Research, Gangnam Severance Hospital, Yonsei University College of Medicine, 211, Eonjuro, Gangnam-gu, Seoul, 06273, Korea
| | - Suk Ho Byeon
- Department of Ophthalmology, Institute of Vision Research, Severance Eye Hospital, Yonsei University College of Medicine, 50-1, Yonseiro, Seodaemun-gu, Seoul, 03722, Korea
| | - Sung Soo Kim
- Department of Ophthalmology, Institute of Vision Research, Severance Eye Hospital, Yonsei University College of Medicine, 50-1, Yonseiro, Seodaemun-gu, Seoul, 03722, Korea
| | - Hyoung Jun Koh
- Department of Ophthalmology, Institute of Vision Research, Severance Eye Hospital, Yonsei University College of Medicine, 50-1, Yonseiro, Seodaemun-gu, Seoul, 03722, Korea
| | - Min Kim
- Department of Ophthalmology, Institute of Vision Research, Gangnam Severance Hospital, Yonsei University College of Medicine, 211, Eonjuro, Gangnam-gu, Seoul, 06273, Korea.
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Yang S, Jiang H, Nie K, Feng L, Fan W. Effect of capsular tension ring implantation on capsular stability after phacoemulsification in patients with weak zonules: a randomized controlled trial. CTR implantation in cataract patients with weak zonules. BMC Ophthalmol 2021; 21:19. [PMID: 33413210 PMCID: PMC7792360 DOI: 10.1186/s12886-020-01772-8] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2020] [Accepted: 12/16/2020] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND The use of capsular tension ring (CTR) implantation to treat cataract patients with weak zonules is still controversial. The aim of this study was to examine the effects of CTR implantation on capsular stability after phacoemulsification in patients with weak zonules, especially patients who have undergone pars plana vitrectomy (PPV) or those who suffer from severe myopia. METHODS A total of 42 patients who underwent phacoemulsification and received an intraocular lens (IOL) were randomized to undergo CTR implantation or not. The control and CTR groups were compared in terms of uncorrected distant visual acuity (UDVA), best corrected distant visual acuity (BCDVA), refractive prediction error, the area of anterior capsulorhexis, and IOL inclination angle. Follow-up visits were conducted postoperatively at 1 day, 1 week, 1 month and 3 months. Subgroup analyses were performed based on PPV and severe myopia. RESULTS Surgery significantly improved UDVA and BCDVA to similar extents in CTR and control patients, and refraction prediction error was similar between the two groups at all follow-up times. At 3 months after surgery, the area of anterior capsulorhexis was significantly larger in CTR patients than in controls (p = 0.0199). These differences were also significant between the subgroups of patients with severe myopia. Vertical IOL inclination was less within CTR groups at 3 months after surgery, especially in patients with severe myopia (p = 0.0286). At 1 week postoperatively, the proportion of individuals whose posterior lens capsule that had completely adhered to the posterior IOL surface was significantly higher among CTR patients (p = 0.023). No serious surgical complications were observed. CONCLUSION CTR implantation can benefit cataract patients with weak zonules by maintaining the shape of the capsular bag, reducing capsule shrinkage and stabilizing IOL inclination. TRIAL REGISTRATION Chinese Clinical Trial Registry ChiCTR-INR-17011217 , date of registration April 22, 2017, prospectively registered.
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Affiliation(s)
- Shangfei Yang
- Department of Ophthalmology, West China Hospital of Sichuan University, Chengdu, 610041, Sichuan Province, China
| | - Hui Jiang
- Department of Ophthalmology, West China Hospital of Sichuan University, Chengdu, 610041, Sichuan Province, China
| | - Kailai Nie
- Department of Ophthalmology, West China Hospital of Sichuan University, Chengdu, 610041, Sichuan Province, China
| | - Liwen Feng
- Department of Ophthalmology, West China Hospital of Sichuan University, Chengdu, 610041, Sichuan Province, China
| | - Wei Fan
- Department of Ophthalmology, West China Hospital of Sichuan University, Chengdu, 610041, Sichuan Province, China.
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Wang Y, Lian Z, Zhou Y, Li X, Wu J, Zhang X, Jin G, Zheng D. Differential diagnosis of Marfan syndrome based on ocular biologic parameters. ANNALS OF TRANSLATIONAL MEDICINE 2020; 8:1354. [PMID: 33313099 PMCID: PMC7723569 DOI: 10.21037/atm-20-1069] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Background The present study aimed to investigate the ocular characteristics of Chinese patients with Marfan syndrome (MFS) and to evaluate the sensitivity and specificity of ocular parameters in distinguishing MFS from ectopia lentis. Methods A total of 103 patients (103 eyes) with ectopia lentis from 13 provinces and 47 cities were recruited from Zhongshan Ophthalmic Center, Sun Yat-sen University, from June 2017 to June 2019. Ghent-2 criteria were used, as they are the gold standard diagnostic criteria for MFS. Ocular parameters, such as flat keratometry (Kf), steep keratometry (Ks), mean keratometry (Km), corneal astigmatism (AST), axial length (AL), white-to-white corneal diameter (WTW), central corneal thickness (CCT), and axial length/curvature radius (AL/CR), were recorded. Diagnostic analyses based on various combinations of parameters to differentiate MFS from ectopia lentis were made using receiver-operating characteristic (ROC) curves. Results The mean age of the 103 included patients was 10.25±9.67 (range: 3–48) years, and 66.02% were male. Km combined with CCT was found to have good sensitivity and specificity in the differential diagnosis of MFS from ectopia lentis; Km of 41.36 D and CCT of 537.32 mm were found to be the optimal cut-off points, representing a sensitivity of 89.8% and specificity of 68.7%. Conclusions Special characteristics of ocular parameters were detected in MFS. Our findings indicate that ocular biologic parameters are valuable for the differential diagnosis of MFS from ectopia lentis. Km, combined with CCT, could be used as a screening tool for MFS.
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Affiliation(s)
- Yiyao Wang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Zhangkai Lian
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Yijing Zhou
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Xuepei Li
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Jieyi Wu
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Xinyu Zhang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Guangming Jin
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Danying Zheng
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
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Gupta G, Sharma S, Arya S, Jinagal J. Bilateral lens subluxation in Marfan syndrome. QJM 2019; 112:383-384. [PMID: 30517757 DOI: 10.1093/qjmed/hcy285] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- G Gupta
- Advanced Eye Centre, Department of Ophthalmology, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
| | - S Sharma
- Department of Ophthalmology, Government Medical College and Hospital, Sector 32, Chandigarh, India
| | - S Arya
- Department of Ophthalmology, Government Medical College and Hospital, Sector 32, Chandigarh, India
| | - J Jinagal
- Department of Ophthalmology, Government Medical College and Hospital, Sector 32, Chandigarh, India
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Chen J, Jing Q, Tang Y, Qian D, Lu Y, Jiang Y. Corneal Curvature, Astigmatism, and Aberrations in Marfan Syndrome with Lens Subluxation: Evaluation by Pentacam HR System. Sci Rep 2018; 8:4079. [PMID: 29511238 PMCID: PMC5840414 DOI: 10.1038/s41598-018-22358-x] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2017] [Accepted: 02/21/2018] [Indexed: 11/25/2022] Open
Abstract
Marfan syndrome (MFS) is associated with abnormalities of corneal biometric characteristics. We conducted a retrospective case-control study including 55 eyes of the MFS patients with lens subluxation and 53 normal eyes of the control subjects to evaluate the corneal curvature, astigmatism and aberrations using a rotating Scheimpflug camera (Pentacam HR). Compared with the control group, the anterior, posterior, and total corneal curvature were flatter in the MFS group. The anterior and total corneal astigmatism were higher in the MFS patients, whereas the posterior corneal astigmatism was not significantly different between the two groups. Regarding the total corneal aberrations, the root mean square (RMS) aberrations, RMS higher-order aberrations and RMS lower-order aberrations increased, whereas the spherical aberration decreased in the MFS patients. Corneal parameters had potential diagnostic values for MFS patients with lens subluxation and the more reasonable cutoffs were the values of corneal curvature <41.35 D, corneal astigmatism >0.85 D and spherical aberration <0.188 μm. Corneal biometric characteristics of MFS patients with lens subluxation include decreased corneal curvature, higher corneal astigmatism, larger corneal aberrations, and lower spherical aberration. Corneal curvature, corneal astigmatism, and spherical aberration are better diagnostic tools for suspicious MFS.
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Affiliation(s)
- Jiahui Chen
- Department of Ophthalmology and Vision Science, Eye Ear Nose and Throat Hospital of Fudan University, Shanghai, China.,Key Laboratory of Myopia of State Health Ministry, and Key Laboratory of Visual Impairment and Restoration of Shanghai, Shanghai, China
| | - Qinghe Jing
- Department of Ophthalmology and Vision Science, Eye Ear Nose and Throat Hospital of Fudan University, Shanghai, China.,Key Laboratory of Myopia of State Health Ministry, and Key Laboratory of Visual Impairment and Restoration of Shanghai, Shanghai, China
| | - Yating Tang
- Department of Ophthalmology and Vision Science, Eye Ear Nose and Throat Hospital of Fudan University, Shanghai, China.,Key Laboratory of Myopia of State Health Ministry, and Key Laboratory of Visual Impairment and Restoration of Shanghai, Shanghai, China
| | - Dongjin Qian
- Department of Ophthalmology and Vision Science, Eye Ear Nose and Throat Hospital of Fudan University, Shanghai, China.,Key Laboratory of Myopia of State Health Ministry, and Key Laboratory of Visual Impairment and Restoration of Shanghai, Shanghai, China
| | - Yi Lu
- Department of Ophthalmology and Vision Science, Eye Ear Nose and Throat Hospital of Fudan University, Shanghai, China.,Key Laboratory of Myopia of State Health Ministry, and Key Laboratory of Visual Impairment and Restoration of Shanghai, Shanghai, China
| | - Yongxiang Jiang
- Department of Ophthalmology and Vision Science, Eye Ear Nose and Throat Hospital of Fudan University, Shanghai, China. .,Key Laboratory of Myopia of State Health Ministry, and Key Laboratory of Visual Impairment and Restoration of Shanghai, Shanghai, China.
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Luebke J, Reinhard T, Agostini H, Boehringer D, Eberwein P. Long-term follow-up after scleral lens fixation in patients with Marfan syndrome. BMC Ophthalmol 2017; 17:235. [PMID: 29207985 PMCID: PMC5718067 DOI: 10.1186/s12886-017-0625-x] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2016] [Accepted: 11/21/2017] [Indexed: 12/04/2022] Open
Abstract
Background The dislocation of the crystalline lens is a common finding in patients with Marfan syndrome (MFS). Scleral intraocular lens (IOL) fixation is an accepted treatment method of this complication. To now, no long-term data on scleral IOL fixation in MFS exist. Methods We present a retrospective study of 27 eyes of 17 MFS patients that underwent scleral lens fixation at our clinic between 1999 and 2012. These patients are compared to an age- and surgeon-matched group of 31 eyes of 27 patients who underwent the same procedure for reasons other than MFS. Results The median age in the MFS group was 35.4 years versus 35.6 years in the non-MFS group. The median follow-up was 4 years for MFS and 3 years for non-MFS. In the MFS group, significantly more IOL-dislocations occurred than compared to the non-MFS group (30% vs. 6.5%, p = 0.02). Retinal detachment occurred in four MFS-eyes compared to three eyes in the non-MFS group. Biometry prediction error was 1.11 diopters (D) for MFS and 1.33 D for non-MFS (p = 0.11). Median BCVA (best-corrected visual acuity, logMAR) was 0.1 in the MFS group versus 0.3 in non-MFS patients. Conclusion Scleral lens fixation in MFS patients achieves satisfying visual and refractive outcomes. Our data shows a significantly higher rate of IOL dislocations in patients with MFS. We therefore recommend addressing this complication preoperatively. Electronic supplementary material The online version of this article (10.1186/s12886-017-0625-x) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Jan Luebke
- Eye Center, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany.
| | - Thomas Reinhard
- Eye Center, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Hansjuergen Agostini
- Eye Center, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Daniel Boehringer
- Eye Center, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Philipp Eberwein
- Eye Center, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
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Yaguchi S, Yaguchi S, Yagi-Yaguchi Y, Kozawa T, Bissen-Miyajima H. Objective classification of zonular weakness based on lens movement at the start of capsulorhexis. PLoS One 2017; 12:e0176169. [PMID: 28426745 PMCID: PMC5398681 DOI: 10.1371/journal.pone.0176169] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2016] [Accepted: 04/06/2017] [Indexed: 11/18/2022] Open
Abstract
Purpose To quantify zonular weakness based on lens movement at the start of continuous curvilinear capsulorhexis (CCC) and establish a classification system for it. Setting Kozawa Eye Hospital and Diabetes Center, Mito, Japan. Design Retrospective interventional case series. Methods We examined 402 consecutive eyes of 316 patients who underwent CCC, phacoemulsification and aspiration (PEA), and intraocular lens (IOL) implantation. The movement of the lens capsule was measured using images from video recordings of the CCC procedure. Zonular weakness was classified based on the shifted distance: Grade I, less than 0.20 mm; Grade II, 0.20–0.39 mm; and Grade III, greater than 0.40 mm. For each of these grades, we examined the use of the capsule stabilization device during PEA, the surgical procedure for lens removal, and IOL fixation. Results We classified 276 eyes (68.6%) as Grade I, 102 eyes (25.4%) as Grade II, and 24 eyes (6.0%) as Grade III. As the grade increased, the use of the capsule stabilization device in PEA and scleral suture fixation of IOL increased. Conclusions Zonular weakness was quantified by measuring the movement of the lens capsule. An objective classification of zonular weakness based on lens movement may be useful for selecting the appropriate device and procedure during cataract surgery.
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Affiliation(s)
- Saori Yaguchi
- Department of Ophthalmology, Tokyo Dental College Suidobashi Hospital, Tokyo, Japan
- Kozawa Eye Hospital and Diabetes Center, Mito, Japan
| | - Shigeo Yaguchi
- Kozawa Eye Hospital and Diabetes Center, Mito, Japan
- * E-mail: ,
| | - Yukari Yagi-Yaguchi
- Department of Ophthalmology, Tokyo Dental College Ichikawa General Hospital, Chiba, Japan
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Rodrigo BJ, Paulina LLE, Francesc MDR, Eduardo TTJ, Alejandro N. Intraocular lens subluxation in marfan syndrome. Open Ophthalmol J 2014; 8:48-50. [PMID: 25279020 PMCID: PMC4181168 DOI: 10.2174/1874364101408010048] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2014] [Revised: 07/21/2014] [Accepted: 07/21/2014] [Indexed: 11/22/2022] Open
Abstract
PURPOSE Ectopia lentis (EL) is a major criteria for the diagnosis of Marfan syndrome, it may vary from an asymptomatic mild displacement to a significant subluxation that places the equator of the lens in the pupillary axis. The purpose of this work is to present the case of a patient with Marfan syndrome who received treatment for subluxation at our institution. CASE REPORT A 51-year-old female diagnosed with Marfan syndrome presented to the emergency department with bilateral eye redness, foreign body sensation and crusting around the eyes on awakening. She had the following history of cardiac and ophthalmologic complications, including: 1. Lens subluxation 2. High myopia 3. Aortic root dilation, 4. Mitral valve prolapse and 5. Tricuspid insufficiency. CONCLUSION The ophthalmological management of Marfan patients is challenging and periodical follow-up is needed. Surgical versus conservative management is controversial, each case needs to be evaluated individually to analyze the risks and benefits of the procedures.
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Affiliation(s)
- Bolaños-Jiménez Rodrigo
- Department of Opthalmology, Regional Hospital Adolfo López Mateos, ISSSTE, Mexico City, Mexico ; Research Unit, Institute of Ophthalmology, Fundación Conde de Valenciana, Mexico City, Mexico
| | - López-Lizárraga E Paulina
- Department of Anterior Segment, Institute of Ophthalmology, Fundación Conde de Valenciana, Mexico City, Mexico
| | - March de R Francesc
- Department of Vitreoretinal Surgery, Institute of Ophthalmology, Fundación Conde de Valenciana, Mexico City, Mexico ; Department of Anterior Segment, Dr. Luis Sánchez Bulnes Hospital, Asociación Para Evitar la Ceguera en México, Mexico City, Mexico
| | | | - Navas Alejandro
- Department of Cornea and Refractive Surgery Institute of Ophthalmology, Fundación Conde de Valenciana, Mexico City, Mexico
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de Alvarenga Yoshida R, Yoshida WB, Kolvenbach R, Pinter L, Roberto Bahdur Vieira P. Retrograde Endovascular Treatment of Internal Iliac Aneurysm in a Patient with Marfan Syndrome. Vascular 2010; 18:235-41. [DOI: 10.2310/6670.2010.00012] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
To report a technique to maintain pelvic flow to an internal iliac artery (IIA) with aneurysm in a patient with Marfan syndrome, and previously treated by infrarenal abdominal aortic aneurysm open procedure. Retrograde endovascular hypogastric artery preservation (REHAP) through flexible endograft implantation from external iliac artery (EIA) to internal iliac artery (IIA) was used. REHAP was a reasonable, minimally invasive and elegant alternative (new) to maintain pelvic arterial flow in Marfan syndrome. However, the long-term durability is unknown, and so, it should be used in selected patients.
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Affiliation(s)
- Ricardo de Alvarenga Yoshida
- *Department of Vascular and Endovascular Surgery, Botucatu School of Medicine, São Paulo State University UNESP, Botucatu, SP, Brazil; †Vascular and Endovascular Surgery Service, Augusta Hospital and Catholic Clinics Düsseldorf, Germany; ‡Angiocenter, São José dos Campos, SP, Brazil
| | - Winston Bonetti Yoshida
- *Department of Vascular and Endovascular Surgery, Botucatu School of Medicine, São Paulo State University UNESP, Botucatu, SP, Brazil; †Vascular and Endovascular Surgery Service, Augusta Hospital and Catholic Clinics Düsseldorf, Germany; ‡Angiocenter, São José dos Campos, SP, Brazil
| | - Ralf Kolvenbach
- *Department of Vascular and Endovascular Surgery, Botucatu School of Medicine, São Paulo State University UNESP, Botucatu, SP, Brazil; †Vascular and Endovascular Surgery Service, Augusta Hospital and Catholic Clinics Düsseldorf, Germany; ‡Angiocenter, São José dos Campos, SP, Brazil
| | - Lazlo Pinter
- *Department of Vascular and Endovascular Surgery, Botucatu School of Medicine, São Paulo State University UNESP, Botucatu, SP, Brazil; †Vascular and Endovascular Surgery Service, Augusta Hospital and Catholic Clinics Düsseldorf, Germany; ‡Angiocenter, São José dos Campos, SP, Brazil
| | - Paulo Roberto Bahdur Vieira
- *Department of Vascular and Endovascular Surgery, Botucatu School of Medicine, São Paulo State University UNESP, Botucatu, SP, Brazil; †Vascular and Endovascular Surgery Service, Augusta Hospital and Catholic Clinics Düsseldorf, Germany; ‡Angiocenter, São José dos Campos, SP, Brazil
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Bibliography. Current world literature. Neuro-ophthalmology. Curr Opin Ophthalmol 2007; 18:515-17. [PMID: 18163005 DOI: 10.1097/icu.0b013e3282f292cf] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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