Intraocular lens dislocation posterior and anterior segment surgical collaboration

Session Details

Session Title: Cataract Surgery Complications/Management

Session Date/Time: Monday 12/09/2016 | 16:30-18:15

Paper Time: 16:42

Venue: Auditorium C6

First Author: : S.Sella ISRAEL

Co Author(s): :    A. Rubowich   J. Ferencz   S. Shin-Ofir   M. Blau-Most   E. Assia   Y. Ton     

Abstract Details

Purpose:

To describe the surgical management and visual outcome of consecutive cases of dislocated intra-ocular lens (IOL) who were surgically repaired by pars plana vitrectomy (PPV) with repositioning and fixation of the dislocated lens or IOL exchange.

Setting:

Retrospective case series of patients who presented with posteriorly dislocated IOL at Meir Medical Center from 2011-2015.

Methods:

Consecutive cases of posteriorly dislocated IOL who were surgically treated between March 2011 and December 2015 were included in this retrospective case series. The data collected included demographic information, details on cataract extraction surgery, visual acuity, surgical management and intraoperative and postoperative complications.

Results:

Twenty cases of posteriorly dislocated IOL were treated over a 6 years period, all required 3 port PPV. The mean age at surgery was 75 years, in average 5.5 years following cataract surgery (range 1 day- 25 years). The main causes of IOL malposition were surgical trauma, post pars plana vitrectomy, blunt trauma, high myopia and pseudoexfoliation. In 18 (90%) the existing IOL was repositioned and sutured to the sclera, the iris or both. 1 Case required IOL exchange and 1 eye was left aphakic. Distance uncorrected visual acuity improved from logMAR 1.56 (range 2. to 0.5) to logMAR 0.7 (range 2.8 to 0.0).Three patients had postoperative transient vitreous hemorrhage and 1 patient had retinal detachment.

Conclusions:

The incidence of IOL malposition is increasing as life expectancy gets longer. Preforming Pars plana vitrectomy is required in cases with the IOL located on the retina or mid/posterior vitreous. Despite the lack of zonular support to the lens, in most cases the existing IOL could be preserved by repositioning and fixating of the lens in the posterior chamber via small incisions within a relatively closed system.

Financial Disclosure:

NONE