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Surgical management of posteriorly subluxated and dislocated crystalline lens

Poster Details

First Author: A.Neves PORTUGAL

Co Author(s):    J. Sousa   J. Campos   S. Mendes   L. Violante   P. Alfaiate  

Abstract Details



Purpose:

Retrospective descriptive study of three clinical cases with posteriorly dislocated crystalline lens based on information from clinical records, patient observation, surgery record and analysis of complimentary diagnostic tests. This work aims to report three different surgical techniques for removal of retained lens fragments secondary to spontaneous dislocation or complicated cataract extraction.

Setting:

Ophthalmology Department, Santo André Hospital, Leiria Hospital Center, Portugal.

Methods:

A 48-year-old female presented with traumatic posterior subluxated crystalline lens and underwent combined 23-gauge pars plana vitrectomy (PPV) and lensectomy. In the second case, a 81 year-old-male with pseudoexfoliation syndrome presented with sudden monocular loss of visual acuity (VA) and has been diagnosed completely posterior dislocation of the total crystalline lens. 23-gauge PPV was performed, and it has been used perfluorcarbon liquid to remove the lens from the vitreous cavity. The lens was then removed through an intracapsular cataract extraction type corneal incision. The third case is a 72-year-old female with posterior retained lens fragments after complicated cataract surgery who underwent 23-gauge PPV and intravitreal phacoemulsification for removal of dislocated lens fragments at the same sitting of phacoemulsification. In the three cases, it has been performed secondary intraocular lens (IOL) implantation (Artisan IOL) for aphakia correction.

Results:

After surgeries, VA improved in the three cases, and was better than 20/40 in 2 of the patients. There was no postoperative retinal detachment or other surgical complications.

Conclusions:

Microincisional PPV can be combined with differents procedures and it is a safe and effective surgical method in the treatment of a subluxated or completely dislocated crystalline lens and retained lens fragments secondary to complicated cataract extraction, trauma or spontaneously. Secondary Artisan IOL implantation is also a safe and effective procedure for vitrectomized aphakic eyes without capsular support. FINANCIAL INTEREST: NONE

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