Safety and Efficacy of Capsular Tension Ring and Capsular Hook Implantation for Managing Ectopia Lentis in Marfan Syndrome: A Real-World Study

Abstract

Objective: To evaluate the safety and efficacy of capsular tension ring and capsular hook (CTR-CH) implantation in Marfan syndrome (MFS) patients with ectopia lentis (EL). Setting: Eye and ENT Hospital of Fudan University Design: Retrospective propensity-score matched cohort study Methods: This study included MFS patients who had in-the-bag intraocular lens (IOL) implantation assisted by CTR-CH or modified capsular tension ring (MCTR). The safety analysis focused on the re-surgery rate. The efficacy analysis compared the best-corrected visual acuity (BCVA) and the incidence of laser capsulotomy after propensity score matching (PSM). Results: This study encompassed 148 eyes that had the CTR-CH procedure and 162 eyes that received MCTR implantation. In the CTR-CH group, the median age at the time of surgery was 5 years old, with a mean follow-up duration of 1.81 ± 0.4 years. Five eyes (3.38%) required a second surgery due to retinal detachment (2, 1.35%), IOL decentration (2, 1.35%), and CH dislocation (1, 0.68%). The re-surgery rate was comparable to that of the MCTR group (P = 0.486). After PSM, a total of 108 patients were recruited in each group. Postoperative BCVA was significantly improved in both groups (both P < 0.001), but comparable between the groups (P = 0.057). The posterior capsular opacification took place earlier (P = 0.046), while the anterior capsular opacification required laser capsulotomy at a later stage (P = 0.037) compared to the MCTR group. Conclusions: The CTR-CH procedure was a feasible, safe, and efficient approach for managing EL in MFS patients.