Surgical Management Of Intraocular Lens Dislocation With Pars Plana Vitrectomy Approach

To analyze the clinical outcomes of patients undergoing dislocated IOL exchange and repositioning with pars plana vitrectomy approach.  

Retrospective, consecutive, single-center, case series of 18 eyes of 18 patients were studied. 

All patients were operated by a single surgeon. In all eyes pars plana vitrectomy was performed with IOL exchange using either scleral fixation (12 cases) or IOL sulcus implantation in case of capsular support (3 cases). In 3 aphakic eyes secondary IOL implantation was performed using scleral fixation technique. Pre- and post-operative best corrected visual acuity (BCVA), intraocular pressure (IOP), post-operative IOL centration, intra-, and postoperative complications were analyzed.

The most common indication was IOL dislocation (n=15), 3 patients were preoperatively aphakic (66.7% men; median age: 71 years). Mean uncorrected VA significantly improved from 0.06±0.02 (logMAR 1.2) preoperatively to 0.4±0.06 (logMAR 0.4) at last follow-up (P < 0.001). 12 eyes (66.7%) met an refractive outcome within ±1.0D, postoperative BCVA was 0.5±0.05 (logMAR 0.3). Previous eye trauma was present in 4; 7 patients had a history of glaucoma. Postoperative IOL centration was good, IOL optic capture was noticed in 2 cases. In 1 case we obsereved anterior nodular postoperative scleritis at the site of intrascleral IOL haptic, which was successfully managed conservatively.  

Dislocated IOL management with pars plana vitrectomy and either scleral fixation or, in case of capsular support, sulcus IOL implantation is safe with good postoperative IOL centration and improved visual acuity and good refractive outcomes.