A classification system of intraocular lens dislocation sites under operating microscopy and surgical techniques and outcomes of exchange surgery

Session Details

Session Title: Cataract Surgery Complications/Management

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

Paper Time: 16:48

Venue: Auditorium C6

First Author: : K.Hayashi JAPAN

Co Author(s): :    S. Ogawa   A. Hirata   K. Yoshimura              

Abstract Details

Purpose:

To examine the recent status of intraocular lens (IOL) dislocation according to a classification system based on vertical dislocation position, and surgical techniques and outcomes of IOL exchange surgery.

Setting:

Hayashi Eye Hospital, Fukuoka, Japan

Methods:

Medical records of 230 eyes of 214 consecutive patients who experienced IOL dislocation and underwent exchange surgery between 2006 and 2014 were reviewed. Vertical dislocation sites observed preoperatively under operating microscopy, and surgical techniques and outcomes of IOL exchange were examined.

Results:

Dislocation sites included 1) the anterior chamber (12.2%), 2) pseudophakodonesis (19.1%), 3) the anterior vitreous cavity (47.4%), 4) trap door-like dislocation (16.1%), and 5) the retinal surface (5.2%). The IOL retained in the anterior segment was moved onto the iris by pulling it up through side ports with an anterior vitrectomy (67.8%), or pushing it up from the pars plana with an anterior vitrectomy (26.5%), while the IOL dropped on the retina was lifting it up from the retina after pars plana vitrectomy (5.7%). Major complications included a marked elevation in intraocular pressure (7.8%) and pupillary capture (6.5%).

Conclusions:

Based on the classification system, approximately 95% of dislocated IOLs were retained in the anterior segment, and these IOLs were exchanged using an anterior approach through limbal incisions with an anterior vitrectomy. Visual acuity improved significantly, and serious complications were uncommon, probably because the IOL exchange techniques were standardized and simplified without pars plana vitrectomy.

Financial Disclosure:

NONE