Using femtosecond laser in pediatric Marfan’s syndrome with ectopia lentis

Bochum, Germany-A femtosecond laser can create circular, well-centered capsulotomies to facilitate implantation of capsular tension rings and IOLs without decentration in pediatric patients with Marfan’s syndrome.

Tim Schultz, MD, and H. Burkhard Dick, MD, of the University Eye Clinic Bochum, Bochum, Germany, described the case of a 10-year-old boy with Marfan’s syndrome.

“The surgical challenges in such cases are the pediatric anatomy-i.e., the small lid, tight orbit, lens ectopia and decentration, high elasticity of the lens capsule, and the increased elongation of the zonules,” Dr. Schultz said.

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The patient had ectopia lentis in both eyes, and was scheduled for cataract extraction in his right eye. The best-corrected visual acuity in the right eye was 20/100. There were no other ocular abnormalities.

The femtosecond laser (Catalys Precision Laser System, Abbott Medical Optics) was used to create a 4.1-mm capsulotomy. A Cionni ring was implanted and sutured to the sclera to center the capsular bag. A foldable IOL was then implanted.

At 7 days postoperatively, the results were very good, Dr. Schultz noted. The capsulotomy was well centered. The bilateral corrected distance visual acuity increased to 20/25. No intraoperative or postoperative complications developed. The patient was followed for 11 months.

“Femtosecond laser has great potential to help in cases of pediatric Marfan’s syndrome,” Dr. Schultz said. “When creating the capsulotomy, we can overcome the challenges, notably the high elasticity of the capsule.

“Femtosecond laser allows creation of a safe, stretchable, circular, well-positioned capsulotomy with a pre-programmed diameter,” he added.

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