SURGICAL OUTCOME OF LATE IN-THE-BAG INTRAOCULAR LENS DISLOCATION TREATED WITH PARS PLANA VITRECTOMY

AIM: To describe a technique of managing intraocular lens (IOL) with deep dislocation in the vitreous cavity by performing pars plana vitrectomy (PPV) with only one pars plana incision under the direct illumination of the surgical microscope. METHODS: Patients who had in-the-bag or out-of-the-bag (spontaneous) IOL dislocation after uneventful phacoemulsification cataract extractions, with the dislocated IOL or IOL-capsular bag complex dropping completely into the vitreous since 2013 were included in our studies. The postoperative patients were followed up for 6mo. Detailed description of technique and retrospective description of eight typical cases were demonstrated in this study. RESULTS: A total of 40 surgeries were conducted using this technique. The main possible predisposing conditions included: post-vitrectomy, posterior capsule rupture or broken zonules, a history of ocular trauma, long axial length, secondary IOL implantation, chronic uveitis, retinitis pigmentosa and post-glaucoma surgery. In all eyes, the IOLs were successfully removed. No intraoperative or postoperative complications related to the procedures occurred. The preoperative corrected distance visual acuity (CDVA) ranged from 20/133 to 20/25, and at 6mo postoperatively, the CDVA was similar or the same. The intraocular pressure was all within the normal range. CONCLUSION: One-port PPV under direct vision with microscope illumination is a simple and safe surgical technique to managing IOL dislocation, which shortens the surgical time, and largely avoids surgical complications.

Download Full-text

Long-term surgical outcomes of primary retropupillary iris claw intraocular lens implantation for the treatment of intraocular lens dislocation

Scientific Reports ◽

10.1038/s41598-020-80292-3 ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Eun Young Choi ◽

Chul Hee Lee ◽

Hyun Goo Kang ◽

Jae Yong Han ◽

Suk Ho Byeon ◽

...

Keyword(s):

Intraocular Lens ◽

Pars Plana Vitrectomy ◽

Case Series ◽

Retrospective Case ◽

Iol Implantation ◽

Intraocular Lens Dislocation ◽

Post Surgery ◽

Pars Plana ◽

Iol Dislocation ◽

Iris Claw

AbstractWe aimed to investigate the efficacy and safety of primary retropupillary iris claw intraocular lens (R-IOL) implantation in patients with complete intraocular lens (IOL) dislocation. In this single-center retrospective case series, we reviewed the medical records of patients who underwent R-IOL implantation surgery with pars plana vitrectomy for the treatment of IOL dislocation between September 2014 and July 2019. The primary outcome was change in visual acuity (VA) up to 24 months postoperatively. The secondary outcomes included changes in intraocular pressure (IOP), refractive errors, and endothelial cell count (ECC) over the same period. Data of 103 eyes (98 patients) were analyzed. The mean uncorrected VA was significantly improved at one month postoperatively (− 0.69 logMAR, P < 0.001), compared to the preoperative value. IOP (− 2.3 mmHg, P = 0.008) and ECC (− 333.4 cells/mm2, P = 0.027) significantly decreased one month post-surgery and remained stable thereafter. Postoperative mean spherical equivalents were similar to the prediction error throughout the follow-up period. IOP elevation (n = 8, 7.8%), cystoid macular edema (n = 4, 3.9%), and dislocation of the R-IOL (n = 10, 9.7%) were managed successfully. Overall, primary R-IOL implantation with pars plana vitrectomy is effective and safe for correcting IOL dislocation due to various causes.

Download Full-text

Recurrent Intraocular Lens Dislocation in a Patient with Familial Ectopia Lentis

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18094545 ◽

2021 ◽

Vol 18 (9) ◽

pp. 4545

Author(s):

Tomasz K. Wilczyński ◽

Alfred Niewiem ◽

Rafał Leszczyński ◽

Katarzyna Michalska-Małecka

Keyword(s):

Intraocular Lens ◽

Pars Plana Vitrectomy ◽

Vision Loss ◽

Silicone Oil ◽

Single Case ◽

Recurrent Dislocation ◽

Ectopia Lentis ◽

Pars Plana ◽

The Right

A 36-year-old patient presented to the hospital with recurrent dislocation of the intraocular lens (IOL). The patient with the diagnosis of familial ectopia lentis was first operated on for crystalline lens subluxation in the left eye in 2007 and in the right eye in 2009. In both eyes, lens extraction with anterior vitrectomy and transscleral fixation of a rigid IOL was performed. In 2011, the IOL in the right eye luxated into the vitreous cavity due to ocular trauma. The patient underwent a pars plana vitrectomy with the IOL resuturation to the sclera. Seven years later, a spontaneous vision loss in the right eye was caused by a retinal detachment. The pars plana vitrectomy with silicone oil tamponade and a consequential oil removal three months later were performed in 2018. The follow-up examination revealed recurrent IOL dislocation in the same eye. Due to a history of previous suture-related complications a decision was made to remove the subluxated rigid polymethyl-methacrylate (PMMA) IOL and fixate to sclera a sutureless SOLEKO FIL SSF Carlevale lens. The purpose of this report is to present a single case of a 36-year-old patient who was presented to the hospital with recurrent dislocation of the intraocular lens. In a three-month follow-up period, a good anatomical and functional outcome was finally obtained with transscleral sutureless intraocular lens. This lens is an option worth considering especially in a young patient with a long life expectancy and physically active.

Download Full-text