Case Reports

Pseudophakic posterior iris chafing syndrome following DUET intraocular lens (IOL) surgery

Case Report Details

First Author: S.Quah UK

Co Author(s):    I. Siso-Fuertes   S. Goel   S. Rehman   J. Dermott   S. Vaswani   C. O'Donnell     

Abstract Details

Purpose:

To report on a cases series of iris chafing syndrome following DUET IOL surgery with the Sulcoflex Trifocal IOL

Setting:

Optegra Eye Hospitals, UK

Report of Case:

Following observations of iris changes in cases where a DUET procedure with Sulcoflex secondary Trifocal IOL (Rayner, Worthing, UK) implantation was undertaken, we systematically reviewed other cases in a retrospective audit. We identified records of 16 patients (23 eyes) who had uncomplicated DUET IOL implantation with a Sulcoflex Trifocal as the secondary lens. Implantation of the sulcus trifocal lens was chosen for spectacle independence/ease of reversibility motivated by the existence of other comorbidities, previous laser surgery or patient concerns about possible visual disturbance post-operatively. Postoperatively, 7 eyes (30% of the total implanted) developed pigment dispersion, 6 eyes (26%) presented signs of iris chafing/transillumination, 6 eyes (26%) showed anterior chamber activity, intraocular pressure was raised in 8 eyes (35%) post-operatively and 1 eye (4%) developed CMO. All these post-operative complications were managed without further surgery and none of the patients experienced lasting sequelae as a result of the iris changes observed. Visual outcomes at distance and near were satisfactory, although two patients (two eyes) elected to have lens exchange, due to non-tolerance of the optical effects of trifocality. No common patient factors were identified in the affected cohort at the time of submission.

Conclusion/Take Home Message:

We report here several cases of pigment dispersion, iris transillumination defects, post-operative inflammation and associated issues observed in eyes implanted with the Rayner Sulcoflex Trifocal when implanted as a part of a DUET procedure. Surgeons should appraise themselves of the intrinsic risks of sulcus-fixated IOLs when considering this option, either as a primary DUET procedure or in cases of pseudophakic refractive consultations where secondary sulcus multifocal IOLs may be an option.

Financial Disclosure:

None