Posters

Surgical management of late-onset intraocular lens dislocations

Poster Details

First Author: A. Belodedova RUSSIAN FEDERATION

Co Author(s):    K. Vinod   M. Frolov   G. Dushina   A. Shradqa           

Abstract Details

Purpose:

To report surgical, visual, and anatomical outcomes following treatment of dislocated intraocular lenses (IOLs) by explantation of IOL - capsular bag complex (CBC) and retropupillary fixation of an iris-claw IOL.

Setting:

Ophthalmic unit of Skhodnya city hospital, Moscow province; People’s friendship university of Russia Medical Institute Department of Ophthalmology, Moscow, Russian Federation.

Methods:

Medical records of 28 cases (28 eyes; male-15, females – 13; age – 74.2+/-7.2 yrs.) admitted between January, 2011 and January, 2016 for surgical management of late–onset IOL dislocations were evaluated. Pre-and postoperative best-corrected visual acuity (BCVA) (logMAR), intraocular pressure (IOP), time interval between IOL implantation and explantation, surgical methods, and complications were recorded. IOL-CBC was explanted through 5mm wide corneal incision. Complex was first dislocated into anterior chamber (AC) on the iris surface using two instruments, breaking posterior synechias, if any, and followed by pupil constriction, anterior vitrectomy and retropupillary implantation of a modified version of an iris-claw IOL.

Results:

Spontaneous IOL-CBC dislocation was identified in 71% cases, posttraumatic – in 29% cases. Six cases (21%) had ocular hypertension. Dislocation sites included: AC – 2 cases (7%), pseudophacodonesis – 25 cases (89%) and anterior vitreous cavity – 1 case (4%). The median time interval between IOL implantation and explantation was – 66.3+/-42.9 months (range 7 – 178 months). Preoperative BCVA and IOP ranged from 2.7 to 0.3 (average (Mean+/-STD) – 1.2+/-0.7) and 7.1 to 30.9 mmHg (average – 15.4+/-6.0), respectively. Postoperative BCVA at last follow up was 0.4+/-0.5 (range from 0 to 2.7). IOP was controlled medically. Oval pupil, not affecting visual acuity, was noticed in 18% cases.

Conclusions:

BCVA improved in all cases after IOL exchange. Explantation of an IOL-CBC through a 5mm corneal incision, which was required to insert an iris claw IOL, was easy and free of complications. The results of the study showed that retropupillary implantation of an iris claw IOL is a safe and effective method of intraocular correction of aphakia in cases with late-onset IOL dislocations. It is least traumatic and needs minimum intraocular manipulations.

Financial Disclosure:

NONE