Posterior Stromal Dissociation After Accidental Intrastromal (Intracorneal) Intraocular Lens Implantation

Published 2023 - 41st Congress of the ESCRS

Reference: PO0348 | DOI: 10.82333/v6m1-xh78

Authors: Reyhan Hazal Kaplan Koruk* ¹ , Mustafa Özsütçü ¹

¹Ophthalmology,Medipol Mega University Hospital,Istanbul,Türkiye

Intraocular lens (IOL) implantation into the corneal stroma is a rare complication that may occur during cataract surgery. In this report, we present a case in which an IOL was accidentally implanted into the corneal stroma, the approach to the case and the changes in anterior segment optical coherence tomography(AS-OCT).

Ophthalmology department at Medipol University Hospital

Cataract surgery was planned for a 52-year-old female patient.A gradual corneal incision was made temporally with a 2.2 mm keratoma.The surgical procedure was performed without any problems until IOL implantation.Strong resistance was encountered when attempting to inject using the Monarch III D cartridge.It was noticed that the IOL had accidentally moved towards the visual axis.The IOL remained folded and was removed with Kelman-McPherson forceps.In the control examination,haze and edema were observed in the incision line.Posterior stromal dissociation was confirmed by AS-OCT.The next day, the intrastromal region was irrigated with a 30G cannula.The patient had minimal corneal opacity at 1st month postoperatively.

The visual level of the patient, whom we followed up with AS-OCT and planned early treatment, was logMAR 0 (20/20). The haze in the corneal incision area disappeared in long-term follow-up.

Cataract surgery is now performed through smaller incisions with many different types of injectors and foldable IOLs. When using the wound-assisted technique for IOL placement, surgeons should be careful not to introduce the IOL into the corneal stroma. Our knowledge of this complication may reduce the incidence of future cases.