Recurrent Intraocular Lens Dislocation in a Patient with Familial Ectopia Lentis

Abstract

A 36-year-old patient presented to the hospital with recurrent dislocation of the intraocular lens (IOL). The patient with the diagnosis of familial ectopia lentis was first operated on for crystalline lens subluxation in the left eye in 2007 and in the right eye in 2009. In both eyes, lens extraction with anterior vitrectomy and transscleral fixation of a rigid IOL was performed. In 2011, the IOL in the right eye luxated into the vitreous cavity due to ocular trauma. The patient underwent a pars plana vitrectomy with the IOL resuturation to the sclera. Seven years later, a spontaneous vision loss in the right eye was caused by a retinal detachment. The pars plana vitrectomy with silicone oil tamponade and a consequential oil removal three months later were performed in 2018. The follow-up examination revealed recurrent IOL dislocation in the same eye. Due to a history of previous suture-related complications a decision was made to remove the subluxated rigid polymethyl-methacrylate (PMMA) IOL and fixate to sclera a sutureless SOLEKO FIL SSF Carlevale lens. The purpose of this report is to present a single case of a 36-year-old patient who was presented to the hospital with recurrent dislocation of the intraocular lens. In a three-month follow-up period, a good anatomical and functional outcome was finally obtained with transscleral sutureless intraocular lens. This lens is an option worth considering especially in a young patient with a long life expectancy and physically active.

Current Evidence for a New Surgical Technique for Scleral Fixation: The Implantation of a Carlevale Lens, a Systematic Review

“…Additionally, 27-gauge sclerotomies could minimize this risk [ 38 ]. Moreover, the Carlevale lens is suggested to be the better choice in cases of recurrent IOL dislocation [ 50 ] and in children-age patients [ 33 ].…”

“…The innovative design of the Carlevale IOL, with the haptics angled anterior to the optic plate and with an overall length of 13.5 mm and a 6.5 mm large optic, seem to improve IOL centration [ 20 , 48 ]. This lens also reduced the risk of iris capture, and was more independent from anatomical variations [ 1 , 48 , 50 ]. The good self-centering of the IOL and its stability appeared to limit the development of macular edema [ 20 ].…”