Dislocation Of Intraocular Lens In Capsule Bag In Long-Term Postoperated Period

We are presenting rare case of IOL dislocation in capsule bag in four years after previously done phacoemulsification. This case is very interesting and unordinary, because we observed dislocation and mobility only of IOL without damage of capsule bag and ligamentum zinni, without fibrotic changes of capsule bag and without posterior cataract.

Operation - reposition and fixation of IOL - was performed in Clinic Visiobud, Kyiv, Ukraine September 2024. 

Femaile 74 years old came to Clinic Visiobud, Kyiv, Ukraine with visual disordes and double vision, depends on head position. During the examination on slit-lamp we diagnosed wrong position of IOL in capsule bag on right eye, IOL could move in capsule bag during moving of eyes, or head. Capsule bag was undamaged and without fibrotic changes, its position was correct, posterior capsule was clear. Analisis of documentation: before operation patient had myopia - 9,0D, IOP - 14mm, eye globe length - 27,6mm. Phacoemulsification was performed August 2020. There were no any complication, or unstandart situations during and after surgery.

Surgical technique: 

Two paracentesis on 3 and 9 hours. Fullfilling of anterior chamber and capsule bag of viscoelastic. Mobilisation of IOL in capsule bag by spatulum. Using of two instruments (spatulums) we made dislocation of optical part of IOL through anterior capsulorhexis on the anterior surface of capsule bag (capture of IOl's optic). Haptic elements left inside of capsule bag. Removing of visco and hydratation of paracentesis.

Second day after operation:

Vis.OD = 70/100; IOP - 15,2mm.Hg

IOL is centrated, optical part is on the anterior capsule and is captured in anterior capsulorhexis.

Patient does'n feel any optical disorders and very satisfied. 

Fixation and centration of IOL is very essentual for patient's satisfaction of visual result after cataract surgery. Capture of optical part of IOL can help to achive IOL centration and stability in cases, where we can observe, or suggest IOL dislocation.