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Risk Factors for Retinal Detachment in Marfan Syndrome After Pediatric Lens Removal
Youssef Abdelmassih1, Régis Lecoge1, Mehdi El Hassani1
1Pediatric Ophthalmology Department (Y.A., R.L., M.E.H., P.D., G.C., F.M., T.C.), Rothschild Foundation Hospital, Paris, France.
Purpose:
To determine retinal detachment (RD) risk factors after lens removal surgery in children with Marfan syndrome (MS).
Design:
Retrospective, case control study.
Methods:
This was an institutional case series including children (age <18 years) with MS who underwent lens removal surgery. Clinical and surgical characteristics were extracted from the children's electronic files: age, axial length (AL), gender, number of surgeries received, intraocular lens (IOL) implantation at the first surgery, complete removal of the capsular bag, and final best-corrected visual acuity. Risk factors associated with RD occurrence were identified.
Results:
Among 158 eyes included (85 children), 35 eyes (22.2%) developed RD during follow-up. Bilateral detachment occurred in 11 patients (45.8%). Age at the time of the lens removal surgery was not different between groups. Children in the RD group had a higher AL (P < .001), longer follow-up, IOL implantation, and capsular residue. Multivariate analysis identified capsular residue (odds ratio, 16.8; 95% CI, 1.9-148.8; P = .01) and AL (odds ratio, 1.3; 95% CI, 1.01-1.7; P = .03) as predictors for RD.
Conclusions:
Children with MS and increased AL were more likely to develop an RD after lens surgery. When considering lens removal surgery in a pediatric population presenting with MS, a complete capsular removal seemed to be the safer option regarding RD risk.
Insights
Children with Marfan syndrome (MS) undergoing lens removal surgery face a higher risk of retinal detachment (RD). Increased axial length (AL) and capsular residue are significant risk factors for RD after this procedure.
Area of Science:
- Ophthalmology
- Genetics
- Pediatric Surgery
Background:
- Marfan syndrome (MS) is a genetic disorder affecting connective tissue.
- Lens abnormalities are common in MS, often necessitating early surgical intervention.
- Retinal detachment (RD) is a serious complication following ocular surgery, particularly in pediatric patients.
Purpose of the Study:
- To identify risk factors for retinal detachment (RD) after lens removal surgery in children with Marfan syndrome (MS).
Main Methods:
- Retrospective case-control study analyzing data from 158 eyes of 85 children with MS.
- Clinical and surgical data, including axial length (AL), intraocular lens (IOL) implantation, and capsular bag status, were extracted.
- Multivariate analysis was used to determine predictors of RD.
Main Results:
- Retinal detachment (RD) occurred in 22.2% of eyes post-surgery.
- Higher axial length (AL) and the presence of capsular residue were significantly associated with RD.
- Capsular residue (OR, 16.8) and AL (OR, 1.3) were identified as independent predictors of RD.
Conclusions:
- Children with Marfan syndrome (MS) and longer axial lengths (AL) have an increased risk of retinal detachment (RD) after lens removal surgery.
- Complete removal of the capsular bag may be a safer surgical approach to mitigate RD risk in this population.
