Complication of foldable single-piece intraocular lens sulcus implantation in a child under two years old

A two-and-a-half-year-old boy presented to Cipto Mangunkusumo Hospital, Jakarta, Indonesia with a white spot on his left eye. He had cataract surgery one year prior at another hospital. On examination, corectopia, anterior synechiae, white plaque between the iris and corneal endothelium, a shallow anterior chamber, and an intraocular lens (IOL) in the posterior chamber were found. As a result, anterior chamber reformation and IOL explantation was performed. Intraoperatively, a foldable single-piece IOL was found in the ciliary sulcus. Hence, extreme inflammatory process after the operation was unavoidable. One month after the procedure, the cornea was opaque without an increase in intraocular pressure. It is recommended to perform IOL implantation only in children over two years of age with a corneal diameter more than 9 mm. A three-piece IOL might be implanted in the area of the ciliary sulcus only if the child needs an immediate IOL implant.

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Ex-PRESS shunt implantation for intractable glaucoma with posterior chamber phakic intraocular lens: a case report

BMC Ophthalmology ◽

10.1186/s12886-020-01784-4 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Rongrong Hu ◽

Wei Xu ◽

Baishuang Huang ◽

Xiaoyu Wang

Keyword(s):

Anterior Chamber ◽

Intraocular Lens ◽

High Myopia ◽

Posterior Chamber ◽

Filtration Surgery ◽

Phakic Intraocular Lens ◽

Glaucoma Filtration Surgery ◽

Shallow Anterior Chamber ◽

The Right ◽

Intractable Glaucoma

Abstract Background Implantation of the posterior chamber phakic intraocular lens has been widely performed to correct high and extreme myopia. Chronic intraocular pressure (IOP) elevation may occur in its late postoperative period. For medically uncontrolled cases, surgical treatment is necessary, and benefits should be weighed against risks when determining whether to remove the lens. Case presentation A 32-year-old man with extremely high myopia presented with progressive blurred vision and medically uncontrolled IOP in the right eye. His past ocular history was significant for bilateral implantable collamer lens (ICL) implantation ten years ago. On ophthalmic examination, the ICL was well placed with a vault height of 456 µm in the right eye. The anterior chamber angles were open but narrow, and mild to moderate trabecular pigmentation was noted. Ex-PRESS glaucoma filtration surgery without ICL removal was performed to control IOP. During surgery, an Ex-PRESS P50 shunt was inserted into the anterior chamber via the front edge of the blue-grey transition zone between the sclera and cornea. Transient hypotony and shallow anterior chamber occurred in the first week after surgery, along with an ICL tilt towards the cornea with reduced vault height. No other complications related to either the ICL or the Ex-PRESS shunt were noted. IOP remained stable at 12 ~ 14 mmHg at the first 3-month follow-up. Conclusions Ex-PRESS glaucoma filtration surgery might be a safe and effective alternative treatment for intractable glaucoma with high myopia and ICL implantation. Careful assessment of the ICL position and anterior chamber angle is necessary to plan the appropriate surgical procedure. A postoperative shallow anterior chamber may result in ICL dislocation.

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Intraocular Lens Dislocation into the Anterior Chamber because of Repeated Eye-Poking in a Patient with Leber’s Congenital Amaurosis

Case Reports in Ophthalmology ◽

10.1159/000505596 ◽

2020 ◽

Vol 11 (1) ◽

pp. 48-53

Author(s):

Abdullah A. Al-Owaid ◽

Motazz A. Alarfaj ◽

Faris A. Alarfaj ◽

Abdulaziz Awad

Keyword(s):

Anterior Chamber ◽

Intraocular Lens ◽

Surgical Intervention ◽

Posterior Chamber ◽

Specific Behavior ◽

Intraocular Lens Dislocation ◽

Single Piece ◽

Posterior Chamber Intraocular Lens ◽

History Of ◽

Leber’S Congenital Amaurosis

The dislocation of a posterior chamber intraocular lens (PC IOL) because of constant eye rubbing is unusual and has never been reported in a child with Leber’s congenital amaurosis (LCA). A 4-year-old full-term girl with an ocular history of LCA presented to the emergency room with a single-piece PC IOL dislocated into the anterior chamber (AC) of the left eye. There was no history of trauma or any other surgical intervention. A specific behavior known as Franceschetti’s oculo-digital sign is a characteristic feature of LCA; this sign consists of repeated pressing, poking, and rubbing of the eyes with knuckles and fingers to stimulate the photoreceptors. This behavior caused the dislocation of the PC IOL into the AC. The dislocated IOL was explanted, and the patient was provided with aphakic glasses.

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Faculty Opinions recommendation of Collagen copolymer posterior chamber phakic intraocular lens supported by the ciliary sulcus to treat myopia: one-year follow-up.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.725290677.793510662 ◽

2015 ◽

Author(s):

Mark Packer

Keyword(s):

Intraocular Lens ◽

Posterior Chamber ◽

Phakic Intraocular Lens ◽

One Year

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Pigmentary Glaucoma After Cataract Surgery with Single-Piece Hydrophobic Intraocular Lens Implanted into the Ciliary Sulcus: Case Report

Journal of Ophthalmology & Clinical Research ◽

10.33140/jocr.05.01.02 ◽

2021 ◽

Vol 5 (1) ◽

Keyword(s):

Intraocular Pressure ◽

Intraocular Lens ◽

Corneal Endothelium ◽

Surgical Intervention ◽

Posterior Segment ◽

The Other ◽

Pigmentary Glaucoma ◽

Single Piece ◽

History Of ◽

Capsular Bag

A 59 years old man presented with a history of phacoemulsification with an hydrophobic intraocular lens implant in his left eye 4 years ago. The biomicroscopy revealed pigments in the corneal endothelium (Krukenberg’s spindle), peripheral transillumination of the iris and intraocular pressure of 52 mmHg in the left eye. Gonioscopy revealed hyperpigmentation of the posterior trabeculate. Posterior segment examination and visual field revealed a cup/disc 0.9 with significant field damage in strategy 10-2. Biomicroscopic ultrasonography showed asymmetric implantation of the IOL loops in the left eye (one loop in the ciliary sulcus and the other in the capsular bag). He underwent antiglaucomatous treatment with adequate control of intraocular pressure, with no need for surgical intervention.

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One-Year Follow-up of Posterior Chamber Toric Phakic Intraocular Lens Implantation for Moderate to High Myopic Astigmatism

Yearbook of Ophthalmology ◽

10.1016/j.yoph.2011.03.001 ◽

2011 ◽

Vol 2011 ◽

pp. 29-31

Author(s):

C.J. Rapuano

Keyword(s):

Intraocular Lens ◽

Posterior Chamber ◽

Intraocular Lens Implantation ◽

Phakic Intraocular Lens ◽

Lens Implantation ◽

One Year ◽

Myopic Astigmatism ◽

High Myopic Astigmatism

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Intra-ocular lens opacification in the anterior chamber leading to loss of vision in an adolescent

Nepalese Journal of Ophthalmology ◽

10.3126/nepjoph.v6i1.10780 ◽

2014 ◽

Vol 6 (1) ◽

pp. 102-104

Author(s):

Mrindu Chaudhry ◽

Keerti Mundey ◽

Shikha Baisakhiya ◽

Sumita Sethi

Keyword(s):

Visual Acuity ◽

Anterior Chamber ◽

Intraocular Lens ◽

Rare Case ◽

Intraocular Inflammation ◽

Posterior Chamber ◽

Ocular Lens ◽

Posterior Chamber Intraocular Lens ◽

Developmental Cataract ◽

Posterior Chamber Iol

Objective: To report a rare case of intraocular lens (ACIOL) opacification in the anterior chamber in an adolescent and to discuss the possible mechanism of its occurrence and the ways of its prevention. Case: A 16-year-old male underwent cataract surgery for developmental cataract with placement of a foldable posterior chamber IOL in the anterior chamber. There was subsequent opacification of the IOL, which was replaced by a scleral fixated posterior chamber intraocular lens. The post-operative visual acuity improved to 6/18. Conclusion: The posterior chamber IOL implanted in the anterior chamber can get opacified possibly due to postoperative intraocular inflammation. DOI: http://dx.doi.org/10.3126/nepjoph.v6i1.10780 Nepal J Ophthalmol 2014; 6 (2): 102-104

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Intraocular lens dislocation: a novel in-situ scleral refixation technique using a 25 Gauge trocar in the anterior chamber

BMJ Open Ophthalmology ◽

10.1136/bmjophth-2018-000174 ◽

2018 ◽

Vol 3 (1) ◽

pp. e000174

Author(s):

Fabrizio Giansanti ◽

Ruggero Tartaro ◽

Tomaso Caporossi ◽

Vittoria Murro ◽

Alfonso Savastano ◽

...

Keyword(s):

Anterior Chamber ◽

Intraocular Lens ◽

Case Series ◽

Cystoid Macular Oedema ◽

Closed Chamber ◽

Intraocular Lens Dislocation ◽

Case Series Study ◽

Single Piece ◽

Pars Plana ◽

Corneal Decompensation

ObjectiveIntraocular lens (IOL) repositioning using a closed-eye approach could be carried out in some selected cases. Our study focuses on the efficacy and safety of a IOL closed-eye repositioning technique using scleral suture, which is performed using a trocar as an intrastromal limbal guide.Methods and analysisThirty-one eyes of 31 patients with late IOL dislocation operated on between January 2015 and May 2017 were included in this retrospective non-comparative consecutive case series study. The patients had a single-piece in-the-bag dislocation or a 3-pieces in-the-bag or out-of-the-bag dislocation. The patients underwent an anterior vitrectomy and a scleral refixation in a closed chamber using a 10/0 polypropylene suture passed through a 25 Gauge trocar inserted in the anterior chamber.ResultsThe mean follow-up time was 19.54 months. Average preoperative best-corrected visual acuity (BCVA) was 0.73 LogMar (±0.21 SD); while average postoperative BCVA was 0.27 LogMar (±0.23 SD). Fifteen patients underwent anterior pars plana vitrectomy (PPV) while 16 patients did not; moreover, two patients underwent PPV. Six patients had an increase of postoperative intraocular pressure, two patients had postoperative decentration, two patients had postoperative cystoid macular oedema, none of the patients had major complications such as retinal detachment, choroidal detachment, malignant glaucoma, irreversible corneal decompensation and endophthalmitis.ConclusionWe can affirm that our technique may be safe and useful in the case of 3-piece in-the bag or out-of the bag dislocated IOLs and also in the case of in-the-bag single-piece dislocated IOLs.

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