2Gazi Üniversitesi, Tıp Fakültesi, Göz Hastalıkları AD., Ankara, Doç. Dr.
3Gazi Üniversitesi, Tıp Fakültesi, Göz Hastalıkları AD., Ankara, Prof. Dr. Purpose: To describe visual results, complications and surgical approach in eyes with posterior chamber intraocular lens (PCIOL) dislocations into the vitreus.
Materials and Methods: A retrospective consecutive case series of patients with dislocated PC-IOL managed surgically between 1999 and 2005. Were included this study the preoperative and postoperative best corrected visual acuities, accompanying ocular pathologies, surgical techniques, follow up periods, preoperative and postoperative complications were all recorded. Preoperative and postoperative visual acuities were compared by using Wilcoxon test.
Results: Twenty five eyes of 24 patients (20 male and 4 female, mean age 52.8±18.7 years) with a mean follow-up period of 12.4±9.4 months were included in this study. Preoperative uncorrected visual acuity was ranging between hand motions and finger counting to 3m and the mean best corrected visual acuity was 0.22±0.18 (0.0–0.8). Accompanying pathologies were detected retinal detachment in 1 eye, giant retinal tear in one eye and vitreous opacities in the other. Nine of the patients underwent IOL repositioning, 14 had IOL exchange (10 with scleral fixation IOL, 3 with PMMA IOL to the sulcus and one with anterior chamber IOL) and 1 had IOL extraction procedure. The mean best corrected visual acuity was 0.25±0.23 (finger counting-0.8) at the first postoperative month which increased significantly to 0.57±0.35 (finger counting – 1.0) at the last follow up visits of those 22 patients who have at least 6 months follow up. There was no significant difference in visual acuities between the IOL reposition and exchange groups (p>0.05). Postoperative complications were retinal detachment in 4 eyes (12.5%), bullous keratopathy in 1 eye (4.1%), subluxation of the sclerally fixated IOL in 1 eye (4.1%), cystoid macular edema in one eye (4.1%) and optic neuropathy in one eye (4.1%). There was no significant difference with respect to complications between the different both surgical techniques (p>0.05).
Conclusion: The visual and anatomical results of surgical treatment of dislocated IOLs in to the vitreous with both IOL repositioning and IOL exchange techniques seems to be successful, however the possibility of significant complications like that retinal detachment should be kept in mind.
Keywords : IOL dislocation, IOL exchange, IOL repositioning