Spontaneous transcorneal extrusion of posterior chamber intraocular lens- clinical case

Poster Details

First Author: A.Martinho Silva PORTUGAL

Co Author(s):    J. Nascimento   J. Henriques           

Abstract Details

Purpose:

To describe a case of spontaneous healing process after extrusion of a posterior chamber intraocular lens (IOL) through the cornea.

Setting:

: Instituto de Retina e Diabetes Ocular de Lisboa

Methods:

Report of a clinical case.

Results:

A 77-year-old man had undergone pars plana vitrectomy (ppv), cerclage after retinal detachment associated with hemovitreous in left eye (LE). Best corrected visual acuity (BCVA) of LE was hand motion. Four years later, he had a recurrent retinal detachment and re-intervation was performed (phacoemulsification, posterior IOL implantation, ppv, endolaser). There was an anterior displacement of inferior half of IOL. He had a new retinal detachment and on surgery silicone oil was introduced. The patient missed some appointments and returned two years later for revaluation referring having a slight discomfort and mild LE pain. On slit-lamp biomicroscopic examination LE showed the IOL in the corneal thickness, that became progressively more anterior until the complete extrusion one month later, always with only a slight discomfort in LE. After acrylic IOL extrusion , the optic IOL was firmly attached against the edges of the cornea, by the haptics ,that remain in the anterior chamber. The optic IOL remained packed against the edges of the wound and acted as a contact lens, allowing spontaneous corneal healing underneath it. The final result was a leucomatous cornea with vascularization of LE. The right eye had a macular pucker with BCVA 8/10.

Conclusions:

Corneal decompensation has been among the most common and visually disabling complications of IOL implantation. In this clinical case, a corneal decompensation secondary to anterior displacement of IOL and anterior chamber silicone oil make it more susceptible to this serious complication. The posterior surface of the acrylic lens was attached with the wound margins and acted as a contact lens enabling a corneal spontaneous healing underneath it.

Financial Disclosure:

No

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