Posterior iris-claw aphakic intraocular lens implantation in subluxated lenses due to Marfan syndrome

Purpose: To evaluate the indications, visual outcomes, and complication rate after posterior implantation of an iris-claw aphakic intraocular lens (IOt.) in subluxated lenses due to Marfan syndrome. Methods: Eyes without adequate capsular support had posterior chamber iris-claw aphakic IOL implantation between 2006 and 2012. Results: This retrospective cohort study comprised 13 eyes of 10 patients (7 female, 3 male; mean age standard deviation, 34.7 +/- 19.6; range 9-61 years). The mean follow-up was 37 months (range 6-74 months). The mean final postoperative best-corrected visual acuity was significantly (0.24 +/- 0.36 logMAR) better at the last follow-up than 1 day preoperatively (0.72 +/- 0.46 logMAR) (p<0.05). There was no significant change in intraocular pressure before and after surgery. The mean endothelial cell density decreased from 2793 +/- 478 cells/mm(2) preoperatively to 2637 +/- 612 cells/mm2 at last follow-up, representing a mean endothelial cell loss of 5.6%. Complications included early transient postoperative hypotony in 2 eyes (15.4%), slight persistent pupil ovalization in 1 eye (7.7%), and retinal detachment in 1 eye (7.7%). Conclusions: The posterior implantation technique of aphakic iris-claw IOL provided good visual outcomes with a favorable complication rate and can be used as a reasonable alternative in subluxated lenses due to Marfan syndrome without adequate capsular support.