Posters

Pigment dispersion after single-piece acrylic intraocular lens implantation

Poster Details

First Author: B. Choy HONG KONG

Co Author(s):                        

Abstract Details

Purpose:

To describe a case of inadvertent ciliary sulcus placement of a single-piece acrylic intraocular lens (IOL) leading to pigment dispersion.

Setting:

A single hospital in Hong Kong.

Methods:

We reported a case of pigment dispersion following uneventful phacoemulsification with inadvertent sulcus placement of a single-piece foldable acyclic IOL. The risk factors for sulcus placement were identified and investigations with light microscopy and scanning electron microscopy were carried out. A literature review on pseudophakic pigment dispersion associated with single-piece acrylic IOL was also performed.

Results:

A woman underwent an uneventful phacoemulsification with posterior chamber IOL (AcrySof SN60WF). She was noted to have pigment dispersion 1 month post-operatively and examination revealed the IOL was located in the ciliary sulcus. Inadvertent placement of the IOL was likely due to pupil constriction before IOL implantation and compromised view due to wound assisted IOL insertion. UBM showed the haptics touching the iris. IOL exchange was performed with subsequent resolution of pigment dispersion. The light microscopy of the explanted IOL revealed the presence of pigmented granules in the optic-haptic junction and the haptics. Scanning electron microscopy showed aggregates of spherical or elliptical disc-shaped structures that ranged from 0.5 micron to 1 micron in dimension, mostly deposited near the haptics.

Conclusions:

We reported a case of unintentional placement of a single piece AcrySof foldable IOL into the ciliary sulcus after uncomplicated phacoemulsification, which led to pigment dispersion and the IOL was explanted. Consistent with literature and recommendations from the manufacturer, this kind of IOL is not suitable for implantation outside the capsular bag. Surgeons should place special attention on the location of the IOL after insertion, especially in high risk cases. We also performed light microscopy and scanning electron microscopy which confirmed the presence of melanin granules over the explanted IOL mainly over the haptic.

Financial Disclosure:

NONE