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The wrong position of pseudophakic IOL: is it always critical?

Poster Details

First Author: K.Khripun RUSSIA

Co Author(s):    S. Astakhov              

Abstract Details



Purpose:

To estimate influence of wrong (overturned) arrangement of the supplementary pseudophakic toric intraocular lens (IOL) in an artiphakic eyes for the visual acuity , IOL stability, IOL pressure and possibility of formation a syndrome of pigmental dispersion .

Setting:

Department of Ophthalmology, Saint Petersburg State medical University, Saint-Petersburg, Russia.

Methods:

In this study we observed 2 artiphakic patients with residual astigmatism where we implanted supplementary toric IOLs but in wrong position. Supplementary pseudophakic IOL( Sulcoflex Toric 653 T) rotated in the moment of implantation . This position isn't recommended by the producer. We decided not to overturn it, because it was very difficult ( narrow pupil, small anterior chamber). Postoperative follow-up was at 1 week, 1 month, 3 and 6 months. Visual and refractive outcomes were evaluated. The position and rotation of the IOLs were documented at all control visits. In all cases UBM images were taken, with the regular control of the intraocular pressure(IOP) and making gonioscopy.

Results:

All the patients had improved UDVA ( uncorrected distance visual acuity) postoperatively - the mean Snellen UDVA 1 month postoperatively was 0,8 +- 0.1, but we observed insignificant hyperopic shift. Visual acuity remained stable throughout the study. The IOL position was stable in both cases. There are no cases of IOP increasing. Despite dense contact of the central departments of the IOL's there were no cases of intralenticular opacification within 6 months of supervision.

Conclusions:

Correct position of Sulcoflex pseudophakic supplementary IOL is very important, because it have a special design of the optic and posterior haptic angulation. But if you make a mistake during implantation and IOL adopted wrong position(overturned) and you can't turn it back it is not so critical. This patients must be control for a long period of time. In cases of IOP increasing or emergence of pigment dispersion syndrome this IOL's have to turn back to the correct position. FINANCIAL INTEREST: NONE

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