Surgical management and outcomes of dislocated intraocular lenses.

OBJECTIVE To evaluate the surgical management and visual acuity outcomes in a large series of patients with dislocated intraocular lenses (IOLs). DESIGN Retrospective consecutive noncomparative case series. PARTICIPANTS All patients who underwent surgical management of dislocated IOLs by two vitreoretinal surgeons at one institution between January 1, 1991, and March 31, 1998. METHODS Demographic and clinical data were abstracted from patients' medical records. MAIN OUTCOME MEASURES Visual acuity at final follow-up and surgical complications. RESULTS The study population consisted of 110 patients, with a median follow-up interval of 50 weeks after dislocated IOL management. Surgical techniques included IOL repositioning in 93 (84.5%) eyes, IOL exchange in 16 (14.5%) eyes, and IOL removal in 1 (1 %) eye. Final visual acuity was > or =20/40 in 63 patients (57%) patients, 20/50-20/200 in 34 (31%) patients, and <20/200 in 13 (12%) patients. Ninety-nine (90%) patients had stable or improved final vision. Observed complications included postoperative retinal detachment in 7 (6.3%) eyes, chronic cystoid macular edema in 19 (17%) eyes, and suprachoroidal hemorrhage in 1 (1%) eye. CONCLUSIONS Surgical management of dislocated IOLs usually results in satisfactory visual outcomes. Pre-existing ocular pathology and postoperative complications may limit final vision.

[1]  H. Flynn,et al.  Retinal detachment in patients with retained lens fragments or dislocated posterior chamber intraocular lenses. , 1996, Ophthalmic surgery and lasers.

[2]  Frank G. Mullins,et al.  Focal points , 1964, IEEE Spectrum.

[3]  L. Girard,et al.  Scleral fixation of a subluxated posterior chamber intraocular lens. , 1988, Journal of cataract and refractive surgery.

[4]  W. Stark,et al.  Surgical management of subluxed posterior-chamber intraocular lenses. , 1993, Archives of ophthalmology.

[5]  R. V. Campo,et al.  Pars plana vitrectomy in the management of dislocated posterior chamber lenses. , 1990, American journal of ophthalmology.

[6]  H. Flynn,et al.  Surgical management of dislocated intraocular lenses , 1995, Journal of cataract and refractive surgery.

[7]  H. Flynn,et al.  Surgical management of posteriorly dislocated silicone plate haptic intraocular lenses. , 1997, American journal of ophthalmology.

[8]  H. Flynn,et al.  Management of subluxated and posteriorly dislocated intraocular lenses using pars plana vitrectomy instrumentation , 1990, Journal of cataract and refractive surgery.

[9]  R. Lindstrom,et al.  Malpositioned posterior chamber lenses: etiology, prevention, and management. , 1985, Journal.

[10]  E. Holland,et al.  Anatomic study of transsclerally sutured intraocular lens implantation. , 1989, American journal of ophthalmology.

[11]  D. Worthen,et al.  Intraocular lenses: complications and visual results. , 1983, Transactions of the American Ophthalmological Society.

[12]  L. Akduman.  Transscleral fixation of a dislocated silicone plate haptic intraocular lens via the pars plana. , 1998, Ophthalmic surgery and lasers.

[13]  L. Girard,et al.  Seleral fixation of a subluxated posterior chamber intraocular lens , 1988 .

[14]  H. Flynn,et al.  Needle-assisted scleral fixation suture technique for relocating posteriorly dislocated IOLs. , 1993, Archives of ophthalmology.

[15]  F. Price,et al.  Explantation of posterior chamber lenses , 1992, Journal of cataract and refractive surgery.

[16]  M. Roper-Hall.  Anterior segment surgery. , 1990, The British journal of ophthalmology.

[17]  H. Flynn,et al.  Management of dislocated posterior chamber intraocular lenses. , 1991, Ophthalmology.

[18]  J. Ruiz-Moreno.  REPOSITIONING DISLOCATED POSTERIOR CHAMBER INTRAOCULAR LENSES , 1998, Retina.

[19]  P. Sternberg,et al.  Treatment of dislocated posterior chamber intraocular lenses. , 1986, Archives of ophthalmology.

[20]  W. Smiddy.  Modification of scleral suture fixation technique for dislocated posterior chamber intraocular lens implants. , 1998, Archives of ophthalmology.

[21]  J. Pulido,et al.  Removal of dislocated intraocular lenses using pars plana vitrectomy with placement of an open-loop, flexible anterior chamber lens. , 1998, Ophthalmology.

[22]  K. Teichmann.  Free‐Hand Precutting of Transverse Keratotomies , 1989, Journal of cataract and refractive surgery.