Toric IOL haptic dislocation management in patient with Marfan syndrome after phacoemulsification and scleral fixation of the modified capsular tension ring

    

    Abstract

    Toric IOL haptic dislocation management in patient with Marfan syndrome after phacoemulsification and scleral fixation of the modified capsular tension ring

    B.E. Malyugin, N.S. Anisimova, I.S. Tkachenko, S.Yu. Kalinnikova

    S. Fyodorov Eye Microsurgery Federal State Institution, Moscow, Russian Federation
A. Yevdokimov Moscow State University of Medicine and Dentistry, Moscow, Russian Federation

    Purpose. To propose a surgical technic for correcting the dislocation of the haptic element of the toric intraocular lens (IOL) in a patient after phacoemulsification and scleral fixation of the modified capsular ring in Marfan syndrome (MS).

    Material and methods. To report a case about dislocation one of the haptic elements of a toric IOL out of the capsular bag as a result of contraction of the capsular bag in a patient with MS in the presence of sutured modified capsular tension ring. The patient underwent a comprehensive ophthalmological examination, including refractometry, eye biometry, ophthalmoscopy, fundus examination for medical mydriasis, keratotopography, computed tomography of the cornea, and surgical treatment.

    Results. Removal and peeling of fibrous tissue, located under the anterior capsule with a reposition of the haptic of toric IOL resulted in significant astigmatism reduction and visual functions improvement.

    Conclusion. The proposed surgical technic for dissection of the anterior capsule fibrosis and reposition of the IOL haptics is effective for restoring the anatomically correct position of the IOL, and also allows to obtain a good functional result. To the best of our knowledge, successful treatment of late postoperative residual astigmatism with IOL tilt under conditions of transscleral fixed modified capsular tension ring (M-CTR) with haptic dislocation from the capsular bag and the presence of contraction capsular syndrome in SM has not been previously described in the literature.

    Key words: Marfan syndrome, capsule contraction syndrome, modified capsular tension ring, phacoemulsification, toric IOL result. To the best of our knowledge, successful treatment of late postoperative residual astigmatism with IOL tilt under conditions of transscleral fixed modified capsular tension ring (M-CTR) with haptic dislocation from the capsular bag and the presence of contraction capsular syndrome in SM has not been previously described in the literature.

    

    For quoting: Malyugin B.E., Anisimova N.S., Tkachenko I.S., Kalinnikova S.Yu. Toric IOL haptic dislocation management in patient with Marfan syndrome after phacoemulsification and scleral fixation of the modified capsular tension ring. Clinical cases in ophthalmology. 2022;1: 6–13.

    

    Corresponding author: Ivan S. Tkachenko, dr.ivan.tka@gmail.com