Session Title: Cataract II
Session Date/Time: Saturday 16/02/2013 | 08:30-11:00
Paper Time: 08:36
Venue: Hall 1
First Author: : O.Le Quoy FRANCE
Co Author(s): :
Purpose:
We present a series of 11 eyes referred with medically uncontroled ocular hypertension associated with subluxated IOL’s producing mecanical iris irritation.
Setting:
private and hospital practice
Methods:
The 11 eyes of 9 patients, (6 women and 3 men) were operated on between January 2006 and June 2012. Mean age was 78 years ((69-97). The mean ocular hypertension was 27 mmHg (20-34) with maximum hypotensive medical treatment. This series includes 4 cases of PCL with major pseudophakodonesis, 2 cases of retraction of the capsular bag with anterior haptic luxation and pupillary distortion, 3 cases of iris fixated IOL’s and 2 cases of ACL with subluxated haptic. One case was associated with MCE and 4 cases with major decrease of endothelial cells counting. In all cases IOL was unstable and produced iris irritation. No eye of the series had pseudoexfollation, uveitis or pigmentary glaucoma.
Results:
Mean duration between diagnosis of hypertension and surgical treatment was 48 months (15 days –10 years). Surgical treatment associated removal of the subluxated IOL with capsular bag or capsulozonlar remnants through a 8mm width suturless sclero-corneal incision, posterior vitrectomy and scleral fixation in the sulcus of a PMMA IOL 7mm optic, 13.5mm haptic diameter and 10° angulated C loop with for 10/0 Prolene sutures. Mean pre-operative visual acuity was 20/50 (20/500-20/20) and mean post-operative visual acuity was 20/35 (20/300-20/20). At J+1 mean post-operative ocular pressure was 13 mmHg (10 -20 mmHg) and 66% of eyes didn’t require further hypotonic drops. Perimetry and microperimetry showed wide and deep scotoma in 40% of cases.
Conclusions:
Subluxated IOL’s with microtraumatic iris irritation can induce severe ocular hypertension with a high risk of optic atrophy. In our series, lense exchange with sceral fixation IOL’s and posterior vitrectomy is a reliable treatment for prevention of additional scotoma and optic atrophy.
Financial Disclosure:
None
