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Traumatic anterior dislocation of the intraocular lens-capsular bag complex

Poster Details

First Author: J.Sandoval Codoni SPAIN

Co Author(s):    J. Sandoval Codoni   I. Baquero Aranda   F. Rosales Villalobos   R. Luque Aranda     

Abstract Details



Purpose:

Report the case of an eye trauma that caused a complete intraocular lens - bag complex dislocation (IOLBCD) into the anterior chamber (AC). And a possible surgical approach to replace the intraocular lens (IOL)

Setting:

Department of Ophthalmology, HCU Virgen de la Victoria, Málaga, Spain

Methods:

71 years old female who visited the emergency room due to a blast injury in the right hemiface after the explosion of an inflammable spray can thrown into the fire. No relevant medical history. As ophthalmological history cataract surgery in both eyes five years ago. The ophthalmological examination revealed a best corrected visual acuity of 20/120 with a normal intraocular pressure. The biomicroscopy showed a clear cornea with an epithelial defect, hematic tyndall , hyphema 2 /10, a complete IOLBCD to the AC and vitreous without affecting the iris sphincter. Funduscopy showed no lesions . Radiological test confirmed the integrity of the bone structures. Oral and topical corticosteroid treatment were prescribed.

Results:

Successive revisions revealed the complex was stable in the AC so porgrammed surgery. was decided. The IOL - bag complex was explanted and replaced by a sutured to iris IOL with a good clinical outcome

Conclusions:

Traumatic dislocation of the IOL may occur to the suprachoroidal space, to the subconjunctival space , to the vitreous cavity and occasionally may be extruded of the eye .There are cases in the literature of in-the-bag IOL anterior dislocation in patients with pseudoexfoliation syndrome The dislocation into the anterior chamber is rare and when it happends can damage the iris. Complex dislocation can range from pseudophakodonesis to the complete dislocation as is our case. Surgical options to a dislocation pass through the replacement or reinstatement but when the dislocation is complete, replacement is recommended with the option to scleral fixation, iris sutured or iris claw.The technique must be individualized because each has its advantages and disadvantages , none has demonstrated overall superiority but maybe yes in certain circumstances The iris sutured IOL seems an effective alternative to the need to explant. FINANCIAL INTEREST: NONE

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