The following is a summary of “Influencing factors of effective lens position in patients with Marfan syndrome and ectopia lentis,” published in the April 2024 issue of Ophthalmology by Shen et al.
Researchers conducted a retrospective study analyzing the influential lens position (ELP) in patients with Marfan syndrome (MFS) and ectopia lentis (EL).
They enrolled patients with MFS who underwent lens removal and primary intraocular lens (IOL) implantation. The back-calculated ELP was obtained using the vergence formula and compared with theoretical ELPs. Evaluation of the back-calculated ELP and ELP error considered demographic and biometric parameters, including axial length (AL), corneal curvature radius (CCR), and white-to-white (WTW) measurements.
The results showed 292 eyes from 200 patients. The back-calculated ELP measured lower in patients with scleral-fixated IOL compared to those with in-the-bag IOL implantation (4.54 IQR 3.65–5.20] mm vs. 4.98 [IQR 4.56–5.67] mm, P<0.001). The SRK/T formula’s theoretical ELP demonstrated the highest accuracy, showing no difference from the back-calculated ELP in patients with in-the-bag IOL implantation (5.11 [IQR 4.83–5.65] mm vs. 4.98 [IQR 4.56–5.67] mm, P=0.209). ELP errors showed significant correlations with refraction prediction error (PE): a 1 mm ELP error led to PE of 2.42 diopters (D) (AL<22 mm), 1.47D (22 mm≤AL<26 mm), and 0.54D (AL≥26 mm). Multivariate analysis uncovered significant correlations of ELP with AL (b=0.43, P<0.001), CCR (b=−0.85, P<0.001), and WTW (b=0.41, P=0.004).
Investigators concluded that their study provides a new understanding of how PE arises in patients with MFS and EL and may lead to improvements in current formulas.
Source: bjo.bmj.com/content/early/2024/04/10/bjo-2023-325017