Page 1 of 5
European Journal of Applied Sciences – Vol. 13, No. 1
Publication Date: February 25, 2025
DOI:10.14738/aivp.131.18154.
Sidibe, M. K., Gnangourou, N., Tepage, J., Simaga, A., Diallo, S., Conare, I., Traore, O. Y., Dembele, F., Traore, K., Diarra, M., Kone,
A. D., Bakayoko, S., & Traore, L. (2025). Management of Ectopic Lens Cataract by Lensectomy, Vitrectomy and Iridial Fixation
Implantation (Artisan): About 02 Eyes of a Child Admitted to CHU IOTA. European Journal of Applied Sciences, Vol - 13(1). 181-
185.
Services for Science and Education – United Kingdom
Management of Ectopic Lens Cataract by Lensectomy, Vitrectomy
and Iridial Fixation Implantation (Artisan): About 02 Eyes of a
Child Admitted to CHU IOTA
Sidibe, M. K.
Tropical Eye Institute of Africa
(CHU IOTA, Bamako / MALI)
Gnangourou, N.
Tropical Eye Institute of Africa
(CHU IOTA, Bamako / MALI)
Tepage, J.
Tropical Eye Institute of Africa
(CHU IOTA, Bamako / MALI)
Simaga, A.
Tropical Eye Institute of Africa
(CHU IOTA, Bamako / MALI)
Diallo, S.
Tropical Eye Institute of Africa
(CHU IOTA, Bamako / MALI)
Conare, I.
Tropical Eye Institute of Africa
(CHU IOTA, Bamako / MALI)
Traore, O. Y.
Unit of the Medical Surgical Center of Bamako's Arms
Dembele, F.
Unit of the Medical Surgical Center of Bamako's Arms
Traore, K.
Unit of the Medical Surgical Center of Bamako's Arms
Diarra, M.
Unit of the Medical Surgical Center of Bamako's Arms
Kone, A. D.
Unit of the Medical Surgical Center of Bamako's Arms
Page 2 of 5
Services for Science and Education – United Kingdom 182
European Journal of Applied Sciences (EJAS) Vol. 13, Issue 1, February-2025
Bakayoko, S.
National Eye Health Program (PNSO),
Faculty of Medicine and Odontostomatology (FMOS) Bamako, MALI
Traore, L.
National Eye Health Program (PNSO),
Faculty of Medicine and Odontostomatology (FMOS) Bamako, MALI
ABSTRACT
Objective: To report two cases of ectopic cataracts in the context of Marfan's
syndrome diagnosed and treated by vitrectomy, lensectomy associated with iridial
fixation implantation with good functional results. Case report: This 16-year-old
patient was admitted to the African Tropical Ophthalmology University Hospital
Center (CHU-IOTA) for a decline in visual acuity since childhood, and was diagnosed
as having Marfan syndrome with bilateral ectopic cataract, taking into account the
Berlin anatomical criteria. Apart from ocular and musculoskeletal involvement,
cardiac, pulmonary, biological and biochemical examinations were normal. After
surgical management with vitrectomy, lensectomy and iridofixation implantation
(artisan), initial visual acuity counts fingers at 1 meter and at 2 meters in the right
and left eyes respectively, improved to 5/10 without correction in both eyes and to
10/10 with optical correction made after postoperative follow-up. Conclusion: Iris- fixation implantation after vitrectomy and lensectomy is an effective surgical
technique that can guarantee good functional results in children with ectopic
cataracts due to Marfan syndrome.
Keywords: Ectopy, lens, Marfan, vitrectomy, lensectomy, Iris implantation, visual acuity,
child.
INTRODUCTION
Lens ectopia is a congenital displacement of the lens, bilaterally and symmetrically, due to a
zonular anomaly. It is often associated with syndromic diseases such as Marfan syndrome. The
latter is an autosomal dominant disorder with an estimated frequency of 1/5,000 individuals
[1], diagnosis of which is based on certain criteria, and management is multidisciplinary. We
report here two cases of ectopic lens cataracts of Marfan syndrome diagnosed and treated by
vitrectomy, lensectomy associated with scleral fixation implantation with good postoperative
functional results.
CLINICAL CASE
This was a 16-year-old student wearing corrective lenses for myopia, with a family history of
his mother's long-sighted morphotype. He was seen in ophthalmology consultation at CHU- IOTA for a progressive drop in visual acuity since childhood. On external examination,
ophthalmology revealed moderate leukocoria with decreased red reflex of the fundus in the
bruckner test, and good oculomotricity. On physical examination, the right eye showed
uncorrected visual acuity at 1 metre and 4/10 with correction, ectopia with lens opacity
(opaque spherophakia, displaced superiorly, abnormally visible zonular fibres elongated
inferiorly, showing a bright red crescent on retro-illumination), intraocular pressure at 10
mmHg and normal fundus. Examination of the left eye revealed uncorrected acuity at 2 metres
Page 3 of 5
183
Sidibe, M. K., Gnangourou, N., Tepage, J., Simaga, A., Diallo, S., Conare, I., Traore, O. Y., Dembele, F., Traore, K., Diarra, M., Kone, A. D., Bakayoko,
S., & Traore, L. (2025). Management of Ectopic Lens Cataract by Lensectomy, Vitrectomy and Iridial Fixation Implantation (Artisan): About 02 Eyes
of a Child Admitted to CHU IOTA. European Journal of Applied Sciences, Vol - 13(1). 181-185.
URL: http://dx.doi.org/10.14738/aivp.131.18154
and 5/10 with corrected glasses, with the same signs in the anterior segment and fundus
(Figure 1).
Figure 1: Ectopia of the lens of the left eye.
General examination revealed musculoskeletal damage (dolichostenomelia with a height of 185
cm, arachnodactyly with walker Murdoch's thumb sign, scoliosis and anteroposterior
dolichocephaly). Cardiovascular examination was normal, with no mitral insufficiency or aortic
dilatation. Pulmonary examination was normal. Biological and biochemical tests (CBC, ESR,
cholesterol, blood glucose, creatinine, azotemia, uricemia, ALT/ASAT, TSHus, blood ionogram)
were also normal.
The diagnosis of Marfan syndrome with bilateral cataractous lens ectopia was made according
to the 1986 Berlin criteria (involvement of two systems + family history of Marfan) and surgical
management by vitrectomy, lensectomy and iridial fixation implantation (artisan) was
proposed. The right eye was operated on first, and the left eye after post-operative follow-up of
the first eye. In the operating room, after the 03 approaches had been set up, an anterior
vitrectomy, a vitreotome lensectomy and an iridium-fixing implant (18.5 dioptres in the right
eye and 20 dioptres in the left eye) were performed (Fig. 2).
Figure 2: Iris fixation implant in the right eye.