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10 - 14 Sept. 2016, Bella Center, Copenhagen, Denmark

This Meeting has been awarded 27 CME credits

 

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Bilateral spontaneous dislocation of in-the-bag intraocular lens

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Session Details

Session Title: Presented Poster Session: Pre/post-op special cases

Session Date/Time: Sunday 11/09/2016 | 15:00-16:30

Paper Time: 15:50

Venue: Poster Village: Pod 1

First Author: : A.Shradqa RUSSIA

Co Author(s): :    K. Vinod   M. Frolov   G. Dushina   A. Belodedova     

Abstract Details

Purpose:

To report a case of spontaneous bilateral in-the-bag intraocular lens (IB-IOL) dislocation and its management.

Setting:

Ophthalmic unit of Skhodnya city hospital, Moscow province, People’s friendship university of Russia Medical Institute Department of Ophthalmology, Moscow, Russian Federation.

Methods:

A case of bilateral spontaneous IB-IOL dislocation was evaluated. A complete ophthalmic examination was carried out preoperatively. Surgically, a corneal incision (5mm) was made at 12 o’clock and anterior chamber (AC) was irrigated with cohesive viscoelastic. A spatula and Sinskey hook were inserted through parasynthesis. Using spatula as fulcrum the complex was dialed out into AC with Sinskey hook and was removed using ‘Dolphin tail’ shaped forceps. Pupil was constricted medically and anterior vitrectomy was performed. A modified version of an iris claw IOL was implanted retropupillary upside down followed by an iridectomy

Results:

An 81-year-old man, who had IOL implantation in both eyes one year back, complained of diminished vision in both eyes. Patient denied history of trauma. Slit-lamp examination revealed infero-medial dislocation of IB-IOL in both eyes, single piece acrylic IOL in right eye and 3-piece IOL with signs of severe fibrosis and  Soemmering's ring in left eye. Though it was not identified at the time of examination, a capsular tension ring (CTR) was also removed at the time of IOL explantation from the right eye. In spite of noticeable pseudophaco-irido-donesis in both eyes, postoperative examinations showed remarkable improvement in visual acuity.

Conclusions:

Bilateral spontaneous IB-IOL dislocation is rare. In this case presence of a CTR in right eye and a 3 piece IOL in left eye indicates that capsular bags in both eyes were already compromised at the time of first surgery. A CTR though could have stabilized the capsular bag during first surgery; it did not prevent late-onset IB-IOL dislocation. We hypothesize that capsular contraction and weak ligaments led to bilateral IB-IOL dislocation. Retropupillary implantation of an iris-claw IOL is a safe and technically easy to perform method of intraocular correction of aphakia in cases with IB-IOL dislocation.

Financial Disclosure:

NONE

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