Posters

Artificial iris subluxation due to memory effect after inverted implant loading

Poster Details

First Author: J.Davo-Cabrera SPAIN

Co Author(s):    J. Piá-Paredes   S. Montolío-Marzo   E. Alfonso-Muñoz   M. Roig-Revert   C. Peris-Martínez        

Abstract Details

Purpose:

To report a case of artificial iris (AI) misplacement after phakic anterior chamber intraocular lens (IOL) explant, cataract surgery, capsular bag IOL and AI implantation.

Setting:

FISABIO Oftalmología Médica, tertiary eye care hospital in Valencia, Spain

Methods:

We report a case of a 60-year-old woman referred to our clinic due to corneal decompensation caused by phakic anterior chamber IOL in her right eye after 27 years. Iris atrophy, permanent mydriasis, anterior synechia and cataract were found. Anterior chamber phakic IOL was explanted through previous scleral incision. Phacoemulsification was performed followed by plate-haptic capsular bag IOL implant. Viscous dispersive viscoelastic was used to prevent further endothelial cell loss. Iris remnants were pulled centrally using retina clamps in order to reduce pupillary aperture. Finally, an 8mm AI was implanted inside the capsular bag.

Results:

Medial corneal edema was reported following the surgery. Using anterior segment OCT showed anterior subluxation of IA in the nasal portion matching with corneal edema. Despite progressive improvement of corneal edema AI did not spontaneously move back to its correct position. Checking the surgery video, we found out that the AI was loaded inverted inside the cartridge, with the anterior pigmented face inwards. Material memory effect due to erroneous cartridge loading may be the cause for continuous AI anterior dislocation. As misplacement is compromising the endothelium, we are planning to change plate-haptic IOL by a double C-loop before AI reposition.

Conclusions:

Careful AI loading in cartridge plays a key role for a correct implant behavious inside the capsular bag. In addition, double-C loop IOL instead of plate-haptic IOL might allow easier AI implantation as greater space is left inside capsular bag.

Financial Disclosure:

None