Pars plana vitrectomy combined with iris-claw intraocular lens implantation for lens nucleus and intraocular lens dislocation

Abstract

Purpose 

To assess the medium-term efficacy and safety of treating nucleus and intraocular lens (IOL) dislocation with pars plana vitrectomy (PPV) combined with iris-claw IOL implantation.

Setting 

Department of Ophthalmology, University of Lyon 1 Claude Bernard, Lyon, France.

Design 

Retrospective case series.

Methods 

The study comprised consecutive patients without capsule support having PPV combined with iris-claw IOL implantation for posterior dislocation of the nucleus or IOL between 2008 and 2012. The preoperative, intraoperative, and postoperative data were retrospectively analyzed. Patients were invited to a prospective final examination at least 6 months postoperatively.

Results 

The study enrolled 32 eyes (31 consecutive patients). The dislocation was spontaneous in 8 cases and traumatic in 24 (intraoperative 17 cases, contusive 7 cases). The iris-claw IOL was on the anterior side of the iris in 19 cases and on the posterior side in 13 cases. The mean corrected distance visual acuity at the end of follow-up was 20/40 or better in 22 patients (69%). The mean spherical equivalent was +8.20 (SD) ± 6.03 diopters (D) preoperatively and −0.51 ± 1.14 D postoperatively. The median endothelial cell loss was 20.5% over the first 3 months. The complications were cystoid macular edema (n = 8), retinal detachment (n = 4), transient intravitreal hemorrhage (n = 4), secondary glaucoma (n = 2), and choroidal detachment (n = 1). The final examination was performed in 27 eyes.

Conclusion 

Treatment of nucleus and IOL dislocation with PPV combined with iris-claw IOL implantation was effective and safe over the medium-term.

Financial Disclosure 

No author has a financial or proprietary interest in any material or method mentioned.