Posters

Subluxation of the lens: choice of surgical tactics

Poster Details

First Author: M. Shanturova RUSSIAN FEDERATION

Co Author(s):                        

Abstract Details

Purpose:

to present the micro-invasive technology of lens removal with irido-vitreal fixation IOL implantation in failure of Zinn ligament fibers.

Setting:

Irkutsk Branch of S. Fyodorov Eye Microsurgery Federal State Institution, Irkutsk, Russia

Methods:

42 eyes of patients aged 55-87 years were operated. Concomitant pathologies were pseudoexfoliative syndrome - 95%, OAG - 56%, myopia - 36%. The surgery is made through 2.2 mm corneal incision. To stabilize the capsular bag iris retractors are used. Phacoemulsification is made in 'slow motion phaco' mode. Then we remove capsular bag with 23g micro pincers atraumatically. For the implantation an elastic IOL of irido-vitreal fixation is used. Then we fix IOL to the iris by 10-00 interrupted suture-loop. At the final stage the basal iridectomy is made by 23 g vitreotome beyond projection of posterior haptics.

Results:

The intraoperative complications - bleeding in 21.3% during the basal iridectomy. In postoperative period - transient ocular hypertension in 34.5%. In 2 cases, additional laser iridectomy was required as the surgical coloboma was blocked by a blood clot. At discharge the visual acuity in most of patients depended on the initial condition and severity of concomitant pathology, and ranged from 0.1 to 0.75. In long-term period 7 patients underwent repeated antiglaucomatous surgery due to IOP subcompensation. During all follow-up period - 3 years - position of the IOL was stable. The postoperative corneal astigmatism did not exceed 0.5 diopters.

Conclusions:

The use of the proposed technology allows rehabilitating patients with lens subluxation atraumatically with minimal risk of intra- and postoperative complications, and eliminating the possibility of spontaneous dislocation of 'IOL - capsular bag' complex in the long-term period.

Financial Disclosure:

NONE