Bilateral dislocation of in-the-bag posterior chamber intraocular lenses in a patient with intermediate uveitis

Brilakis, Harilaos S.; Lustbader, Jay M.

doi:10.1016/s0886-3350(03)00226-8

Cited by 34 publications

(19 citation statements)

References 9 publications

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“…Careful review of the literature revealed 72 subsequent cases (Table 1). [8][9][10][11][12][13][14][15][16][17][18][19][20][21][22][23][24][25][26][27] Several case series reporting the management of IOL dislocation included a small number of ''in-the-bag dislocated lenses'' without presenting further information and thus were not included in the present review. 28,29 The exact incidence of this complication is not known.…”

Section: Incidencementioning

confidence: 99%

“…Pseudoexfoliation was the most common, accounting for more than 50% of cases. Other common conditions were uveitis, 7,21,23 trauma, 11,16,23 vitrectomy, 12,21,23 and increased axial length. 11,17 One or more mechanisms may have resulted in postoperative capsule dislocation: preoperative zonular weakness, surgical trauma to the zonules, capsule contraction syndrome, and postoperative trauma.…”

Section: Proposed Mechanismsmentioning

confidence: 99%

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Late in-the-bag intraocular lens dislocation: Incidence, prevention, and management

Gimbel

Condon²,

Kohnen³

et al. 2005

Journal of Cataract and Refractive Surgery

274

263

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Dislocation of an intraocular lens (IOL) with the capsular bag is a late complication of cataract surgery, reported with increasing frequency in recent years. Pseudoexfoliation, uveitis, myopia, and other diseases associated with progressive zonular weakening and capsular contraction are the predisposing conditions. Capsular tension rings probably help but do not prevent this complication. Management includes IOL exchange, replacement with an anterior or a sutured posterior chamber IOL, or suturing the IOL through the bag to the iris or the sclera.

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Section: Incidencementioning

confidence: 99%

Section: Proposed Mechanismsmentioning

confidence: 99%

Late in-the-bag intraocular lens dislocation: Incidence, prevention, and management

Gimbel

Condon²,

Kohnen³

et al. 2005

Journal of Cataract and Refractive Surgery

274

263

View full text Add to dashboard Cite

show abstract

“…Intraocular lens dislocations can be divided into in-the-bag and out-of-the-bag with correspondingly different etiologies. [1][2][3] The most common etiologies for in-the-bag dislocation are pseudoexfoliation and prior vitreoretinal surgery, whereas out-of-the-bag dislocation usually occurs because of capsule rupture during cataract surgery. Intraocular lens dislocation may be immediate (out-of-the-bag dislocation) or may develop months or years after surgery (in-thebag dislocation).…”

Section: Jcrs Online Case Reports 2015; 3:1-3 Q 2015 Ascrs and Escrsmentioning

confidence: 99%

Back and forth in-the-bag intraocular lens dislocation

Alharbi¹,

Al-Huthail²

2015

Journal of Cataract and Refractive Surgery Online Case Reports

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A 65-year-old man with high axial myopia had uneventful bilateral phacoemulsification. Postoperatively, the patient experienced blunt trauma to his right eye resulting in traumatic mydriasis, a retinal giant tear, and rhegmatogenous retinal detachment that was repaired by pars plana vitrectomy, fluid-air exchange, endolaser, and octafluoropropane tamponade. Four years later, the condition was complicated by posterior dislocation of the in-the-bag intraocular lens (IOL) that was misdiagnosed by the ophthalmologist as aphakia because dilated fundus examination was not performed. A year later, the patient presented to our clinic with decreased vision from a decompensated cornea and anterior dislocation of the in-the-bag IOL into the anterior chamber.Financial Disclosure: Neither author has a financial or proprietary interest in any material or method mentioned. JCRS Online Case Reports 2015; 3:1-3 Q 2015 ASCRS and ESCRSLate dislocation of an intraocular lens (IOL) is an infrequent but serious complication of cataract surgery. Intraocular lens dislocations can be divided into in-the-bag and out-of-the-bag with correspondingly different etiologies. 1-3 The most common etiologies for in-the-bag dislocation are pseudoexfoliation and prior vitreoretinal surgery, whereas out-of-the-bag dislocation usually occurs because of capsule rupture during cataract surgery. Intraocular lens dislocation may be immediate (out-of-the-bag dislocation) or may develop months or years after surgery (in-thebag dislocation). Risk factors for in-the-bag dislocation include pseudoexfoliation, high myopia, trauma, connective tissue disorders, uveitis, and retinitis pigmentosa. 4 Vision loss after IOL dislocation is typically sudden, but it may be gradual when associated with progressive IOL dislocation, cystoid macular edema, retinal detachment, or corneal decompensation secondary to endothelial cell loss.The purpose of this report is to highlight the importance of regular dilated fundus examination of pseudophakic patients, especially those with risk factors such as pseudoexfoliation, trauma, high myopia, history of vitreoretinal surgery, and presence of other ocular or systemic comorbidities. CASE REPORTA 65-year-old highly myopic man was referred to the King Khaled Eye Specialist Hospital with a history of gradual decrease of vision in both eyes because of cataract and a corneal scar. Bilateral phacoemulsification and posterior chamber IOL implantation were performed, and lamellar keratoplasty was performed at a later date in the left eye. All surgeries were uneventful.Five months postoperatively, the patient sustained ocular trauma to his right eye that resulted in traumatic mydriasis, a self-sealed scleral laceration, and macula-on rhegmatogenous retinal detachment, which was repaired with pars plana vitrectomy, fluid-air exchange, and endolaser followed by air-gas exchange with octafluoropropane. The right eye remained stable with a corrected distance visual acuity (CDVA) of 20/80 for 4 years. Subsequently, the patient was seen in a clini...

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“…Although malpositioning of the intraocular lens (IOL) is rare in the modern cataract surgery era, but several predisposing conditions like pseudoexfoliation [1,2], uveitis [3,4], trauma [5] or anterior capsular phimosis can lead to either subluxation or dislocation of bag-IOL complex [6]. In contrast to IOL dislocation, bag dislocation occurs as a result of progressive zonular dehiscence even after years of uneventful surgery.…”

Section: Introductionmentioning

confidence: 99%

Scleral Fixation of Sinking Bag-IOL Complex: A New Surgical Technique

Ram¹,

Singh²,

Hemanth³

et al. 2017

J Clin Exp Ophthalmol

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Treatment options for symptomatic subluxated or dislocated IOLs include observation; and repositioning, removal, or exchange of the IOL. We describe a surgical technique of trans-scleral suture fixation for subluxated bag-IOL complex. A 29 year old male; known case of bilateral recurrent tubercular panuveitis underwent left eye phacoemulsification with three piece hydrophobic acrylic IOL implantation a decade ago. He presented with decreased vision and monocular diplopia since one week. A diagnosis of subluxated bag-IOL complex was made. A 9-0 polypropylene suture was passed beneath the opposite scleral flaps and was taken out through superior stab incision. After exteriorizing both the haptics, they were sutured with prolene. Bag-IOL complex was centered and was fixated trans-sclerally under the scleral flaps. The bag-IOL complex remained stable and well centered 12 months following trans-scleral suture fixation with good visual outcome. This technique can be used in any case of postoperative bag-IOL complex subluxation or dislocation to achieve stabilization.

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Bilateral dislocation of in-the-bag posterior chamber intraocular lenses in a patient with intermediate uveitis

Cited by 34 publications

References 9 publications

Late in-the-bag intraocular lens dislocation: Incidence, prevention, and management

Late in-the-bag intraocular lens dislocation: Incidence, prevention, and management

Back and forth in-the-bag intraocular lens dislocation

Scleral Fixation of Sinking Bag-IOL Complex: A New Surgical Technique

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