Repositioning dislocated posterior chamber intraocular lenses.

Abstract

Removing a dislocated posterior chamber intraocular lens (IOL) is a hazardous procedure that may lead to severe complications and visual loss. A new technique for handling this complication by means of vitrectomy to help replace the luxated IOL directly in the anterior chamber is described. Five patients (two men and three women) underwent surgery for replacement of a luxated posterior chamber IOL in the vitreous cavity. The average age was 67.4+/-8.9 (years+/-SD); range, 57-79 years. Before and after vitrectomy, specular microscopy study of the corneal endothelium was done. The results obtained in these five patients were highly satisfactory, with an average final visual acuity of 20/32 and residual refraction of -1.125+/-1.33. There was no evidence of corneal endothelium decompensation. In one patient, a retinal detachment occurred after 7 months, which was operated successfully. This technique-which allows permanent, stable, and controllable replacement of an IOL with minimal trauma to the iris and corneal endothelium-avoids postoperative induced astigmatism. The technique is useful for IOL with and without positioning holes. No corneal incision is needed; the standard sclerotomies for vitrectomy are used.