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Session Title: Subluxed IOLs and Scleral Fixation
Session Date/Time: Wednesday 09/10/2013 | 08:00-10:30
Paper Time: 08:43
Venue: E102 (First Floor)
First Author: : A.Vicente PORTUGAL
Co Author(s): : V. Lemos A. Santos N. Marques J. Branco J. Feijćo
To present the surgical management with anterior chamber IOLs of 10 patients with spontaneous IOL and capsular bag subluxation.
Spontaneous subluxation of the IOL and capsular bag complex after cataract surgery is a recurrent serious but rare complication. Pseudoexfoliation has been associated with this complication. Nevertheless, risk factors and incidence have yet to be studied. Symptoms include diminished visual acuity and blurry vision. The slit-lamp examination is a fundamental step in the diagnosis of this complication. There are various possible surgical treatments, including posterior or anterior segment approaches and different types of IOLs can be used.
10 eyes of 9 patients were operated by the same surgical team in the last two years. Eight patients had pseudoexfoliation syndrome. Six of the removed lenses were 3 piece AR-40® lenses, three were Alcon Acrysof® monobloc lenses and one was a Bausch & Lomb MI60® lens. The surgical management consisted in a pars plana vitrectomy with IOL and capsular bar complex detachment, IOL removal by corneal incision and anterior chamber iris supported IOL implantation.
There were no intraoperative complications. Pre-operative average visual acuity was 0,16 and post-operative was 0,62 (average visual acuity increase of 0,46). The average follow-up duration was 8 months. 30% of the eyes had a post-operative complication, including high intraocular pressure that was managed with topical therapy, cystoid macular oedema and a desenclavated lens claw.
The technique described in this work is relatively simple, quick and easy to perform. Patients can be operated under topical anaesthesia without great intraoperative risks. The visual recovery rates were good. Nine eyes were able to keep or only decrease one line of visual acuity when compared with visual acuity values before the subluxation.
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