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Bulgarian Review of Ophthalmology

Late dislocation of monoblock lenses implanted in the bag

I. Shandurkov

Abstract

Aim: To demonstrate two different approaches in surgical treatment of dislocated monoblockm intraocular lenses, implanted uneventfully in the bag five or more years ago.

Methods: Pseudoexfoliation syndrome is the major cause of late dislocation of lens and capsular bag complex, years after uneventful cataract surgery. We divided our patients into two groups: Group 1 - Iris fixation of the same lens with 10/0 Prolene suture (reserved for mild lens dislocation out of the plane of visual axis, but still floating behind the pupil); Group 2 - Exchange of the old lens with implantation of Artisan iris claw lens (for cases with luxation deep into vitreous cavity, in combination with pars plana vitrectomy).

Results: In both groups visual acuity improved. Patients with coexisting pseudoexfoliation glaucoma needed additional systemic treatment of elevated intraocular pressure for a period of 3 to 7 days. Average postoperative endothelium cell count loss was higher in the group with lens exchange, due to lavage coming from pars plana infusion line. Quantity of pigment dispersion and deposition over the lens surface was equal in both groups, as in both situations there were contacts between the lens and the iris.

Conclusions: There is no universal approach in cases with dislocated lenses implanted in the bag. It depends on the severity of luxation and need of vitrectomy during repair. In all cases special attention should be paid to intraocular pressure, as it is well known pseudoexfoliation glaucoma can evolve and progress during time.

Keywords

IOL luxation; pseudoexfoliation syndrome; vitrectomy

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References

Balestrazzi A, Tosi GM, Alegente M, Mazzotta C, Esposti PL, Berni E, Michieletto P, Caporossi T. Spontaneous in-the-bag intraocular lens luxation into the vitreous cavity: last-stage complication of pseudoexfoliative syndrome after phacoemulsification. Ophthalmologica, 2009;223(5):339-42

Ascaso FJ, Huerva V, Grzybowski A. Epidemiology, Etiology, and Prevention of Late IOL-Capsular Bag Complex Dislocation: Review of the Literature. J Ophthalmol. 2015;2015:805706.

Siegel MJ, Condon GP. Single suture iris-to-capsulorhexis fixation for in-the-bag intraocular lens subluxation. J Cataract Refract Surg. 2015 Nov;41(11):2347-52.

Gicquel JJ, Langman ME, Dua HS. Iris claw lenses in aphakia. Br J Ophthalmol. 2009 Oct;93(10):1273-5.

Kim KH, Kim WS.Comparison of clinical outcomes of iris fixation and scleral fixation as treatment for intraocular lens dislocation. Am J Ophthalmol. 2015 Sep;160(3):463-469.

Helvaci S, Demirduzen S, Oksuz H. Irisclaw intraocular lens implantation: Anterior chamber versus retropupillary implantation. Indian J Ophthalmol. 2016 Jan;64(1):45-9.

Güell JL, Morral M, Gris O, Gaytan J, Sisquella M, Manero F. Five-year follow-up of 399 phakic Artisan-Verisyse implantation for myopia, hyperopia, and/or astigmatism. Ophthalmology. 2008 Jun;115(6):1002-12.

Schulze SD, Bertelmann T, Manojlovic I, Bodanowitz S, Irle S, Sekundo W. Changes in corneal endothelium cell characteristics after cataract surgery with and without use of viscoelastic substances during intraocular lens implantation. Clin Ophthalmol. 2015 Nov 6;9:2073-80.

Hazar L, Kara N, Bozkurt E, Ozgurhan EB, Demirok A. Intraocular lens implantation procedures in aphakic eyes with insufficient capsular support associated with previous cataract surgery. J Refract Surg. 2013 Oct;29(10):685-91.

Kohnen T. Pseudoexfoliation: Impact on cataract surgery and long-term intraocular lens position. J Cataract Refract Surg. 2010 Aug;36(8):1247-8.

Petrovic MJ, Vulovic TS, Vulovic D, Janicijevic K, Petrovic M, Vujic D. Cataract surgery in patients with ocular pseudoexpholiation. Ann Ital Chir. 2013 Nov- Dec;84(6):611-5.

Hong Y, Sun YX, Qi H, Zhou JC, Hao YS. Pigment dispersion glaucoma induced by the chafing effect of intraocular lens haptics in Asian eyes. Curr Eye Res. 2013 Mar;38(3):358-62.




DOI: http://dx.doi.org/10.14748/bro.v0i4.4559

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About The Author

I. Shandurkov
Eye Hospital `VISION` Sofia
Bulgaria

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