Posters

Early repositioning of misaligned toric posterior chamber phakic intraocular lens

Poster Details

First Author: M.Mestanoglu TURKEY

Co Author(s):    B. Toygar   O. Yabas Kiziloglu   O. Toygar              

Abstract Details

Purpose:

To describe a case of early repositioning of a misaligned toric posterior chamber phakic intraocular lens (PCPIOL) in a 24-year-old patient with mixed astigmatism following PCPIOL implantation with simultaneous peripheral iridectomy.

Setting:

Bahcesehir University School of Medicine, Medical Park Hospital, Goztepe, Istanbul, Turkey

Methods:

A 24-year-old man with preoperative refraction of +5.00x-4.25x25° and +5.75x-5.00×160° in the right and left eye respectively, underwent toric PCPIOL (VTICH model, Visian ICL, Staar Surgical, Nidau, Switzerland) implantation with simultaneous peripheral iridectomy. Peripheral iridectomy was performed with vitrectomy cutter after the PCPIOL implantation. Autorefraction measurement in the right eye was +0.50x-0.25x25° with an uncorrected visual acuity (UCVA) of 0.8 after an uneventful surgery. In the left eye, however, postoperative first week UCVA was 0.1 and best corrected visual acuity (BCVA) was 0.7. Autorefraction measurement was +2.00x-4.75×8° and slit lamp examination demonstrated 18° clockwise misalignment of the IOL.

Results:

Intraocular lens repositioning was performed for the correction of PCPIOL misalignment. Postoperative slit lamp examination revealed the PCPIOL was realigned to the correct position. Autorefraction measurement was +0.50x-1.50×180° for the left eye on postoperative day one. UCVA increased to 0.4 and BCVA remained 0.7 in the left eye. Photorefractive keratectomy is planned for corneal astigmatism three months after the PCPIOL repositioning surgery.

Conclusions:

We suppose the most probable reason for misalignment of this PCPIOL was miosis induced by Miostat (Alcon Laboratories, Inc., Fort Worth, TX) before peripheral iridectomy procedure. Toric PCPIOLs require precise positioning and must preserve this alignment over time, otherwise it may result in unexpectedly high refractive errors and significantly decreased visual acuity in the early postoperative period. Surgeons should be aware of the possibility of misalignment of toric PCPIOLs while performing peripheral iridectomy with vitreous cutter.

Financial Disclosure:

None