IRetropupillary OCT imaging of the enclavation of iris-fixated posterior chamber IOL (Verisyse® aphakia)

Session Details

Session Title: Imaging Anterior Segment

Session Date/Time: Monday 07/09/2015 | 14:30-16:30

Paper Time: 14:58

Venue: Room 11

First Author: : U.Vossmerbaeumer GERMANY

Co Author(s): :    N. Kaplan                    

Abstract Details

Purpose:

Retropupillary positioning of iris-fixated Verisyse® IOL has become a standard surgery as primary or secondary procedure for the correction of aphakia. Typically, evaluation of the enclavation is done indirectly by slit-lamp biomicroscopy. The purpose of our study is to evaluate optical coherence tomography (OCT) as a tool to analyze the quality of the enclavation of the IOL within the iris.

Setting:

Retrospective consecutive case series in a university hospital University of Mainz Medical Centers, Germany

Methods:

30 eyes of 30 consecutive patients were included in the study. All presented with luxation or subluxation of primary pseudophakic IOL together with the capsular bag due to zonulolysis. IOL and bag were explanted and aphakia was corrected with retropupillary fixation of an iris fixated IOL (Verisyse® aphakia VRSM54, AMO Inc.). On d2 post OP the anchoring of the implant in the iris was assessed by OCT (Spectralis® OCT, Heidelberg Engineering) along the pincer haptics and across their junction point. Imageability and positional analysis were evaluated.

Results:

Retropupillary fixation of IOL was performed in all cases. Focused imaging of the haptics through the iris was possible in 52 haptic pairs. Pigmentation of the iris and peripheral placement of the enclavation were limiting factors. The PMMA haptics could be detected longitudinally and transversally and offset of the haptic branches > 50 µm was demonstrated in 50 haptic pairs. Quantitative analysis of the enclavation depth and geometry could be performed. Enclavation patterns were different in eyes with intact iris and those with preexisting defects in the stroma and pigment epithelium.

Conclusions:

Anterior segment SD-OCT is a feasible tool to assess the enclavation of pincer haptics on the posterior side of the iris and within the iris tissue. This may reveal information hitherto unknown about the intrastromal course and junction point of the branches within the irideal pigment epithelium and stroma. Particularly for situations of pseudophaco- and iridodonesis this can be valuable to verify firm enclavation and recognize an eventual risk of subluxation.

Financial Interest:

NONE