A Broader Role for Phakic IOLs

Advances in design and candidacy are moving phakic IOLs earlier in the refractive conversation while preserving future treatment options.

Erik L. Mertens, MD, FEBO, FWCRS, FEBOS-CR, Rex Hamilton, MD, MS, FACS

Cataract and Refractive Surgery Today

Femtosecond Laser AKs versus Toric IOLs for the Correction of Low-Magnitude Astigmatism During Cataract Surgery

For low astigmatism, femtosecond laser AKs achieved outcomes comparable to low-power toric IOLs.

Gary Wörtz, MD

Cataract and Refractive Surgery Today

Scleral Dehiscence Following PPV in a Patient With Marfan Syndrome

Consider a surgical approach that can better accommodate a thin sclera in patients with this connective tissue disorder.

Hind Safi, MD; Younes Tlemçani, MD, PhD; Sarah Belghmaidi, MD, PhD; and Abdeljalil Moutaouakil, MD, PhD

Retina Today

KEY TAKEAWAYS Marfan syndrome (MFS) is a genetic disease affecting connective tissue with autosomal dominant transmission; broad involvement occurs, including cardiovascular, musculoskeletal, dermatological, and ocular complications. The authors report a case of a 34-year-old woman with MFS who developed elevated, uncontrolled IOP following 23-gauge PPV for the repair of a retinal detachment in her left eye and a 360° prophylactic laser retinopexy in her right eye. The authors propose that a scleral patch graft may have been more appropriate for closing the compromised thin sclera in this patient with MFS. Marfan syndrome (MFS) is an autosomal dominant genetic disease affecting connective tissue. The defect lies in the FBN1 gene on chromosome 15, encoding fibrillin, an extracellular matrix glycoprotein.1,2 Broad involvement occurs in MFS, notably with cardiovascular, musculoskeletal, dermatological, and ocular effects.3,4 Ocular manifestations include ectopia lentis, microspherophakia, myopia, glaucoma, retinal tears, and retinal detachment (RD).5 In this article, we describe a rare case of scleral dehiscence following 23-gauge pars plana vitrectomy (PPV) for RD repair in a patient with MFS. This case highlights the potential effects of MFS on the scleral tissue following PPV, identifies contributing factors, and offers ways to anticipate them for future surgical interventions. CASE REPORT A 34-year-old woman with MFS presented with a sudden decrease in vision in her left eye. She had undergone intracapsular lens extraction and iris clip IOL implantation for bilateral crystalline lens subluxation 2 years earlier. On examination, her BCVA was 20/20 OD and hand motion OS. She was highly myopic with an axial length of 28.72 mm OD and 27.59 mm OS.