Spontaneous Late Intraocular Lens and Capsule Tension Ring Dislocation

Altıntaş, Ayşe; Omay, Aslıhan Esra; Çelik, Selda

doi:10.4274/tjo.79836

Cited by 11 publications

(9 citation statements)

References 23 publications

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“…If CTR is implanted in case of weak zonules caused by pseudoexfoliation syndrome, most procedures are performed without additional fixation by suturing, and the method shows good visual, positional (IOL well centered), and long-term outcome. Thus, the particular procedure was used as a method of choice in the present case; however, late in-the-bag IOL dislocations have been reported in this group of patients, developing from 2.5 to 8.5 years after the initial surgery [8,9,13]. Anterior capsular phimosis as one of possible causes of late IOL dislocation was observed in our case, despite appropriate treatment (Nd:YAG laser capsulotomy) 2 months postoperatively.…”

Section: Discussionmentioning

confidence: 64%

“…To improve surgical outcome and long-term prognosis, different devices for weak zonule management have been introduced such as conventional and modified capsular tension rings (CTRs) and iris and capsular hooks [4][5][6]. Late in-the-bag intraocular lens (IOL) and CTR complex dislocation may develop, despite the use of different devices for weak zonule cases in a period of ≥3 months after cataract surgery [7][8][9][10].…”

Section: Introductionmentioning

confidence: 99%

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Long-Term Outcome of Cataract Surgery in Eyes with Pseudoexfoliation Syndrome Associated with Weak Zonules: A Case Report

Vanags

Laganovska

2020

Case Rep Ophthalmol

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A cataract surgery in both eyes was scheduled for an 81-year-old female patient. However, ophthalmic examination revealed marked iridodonesis, phacodonesis and pseudoexfoliative material on the surface of the lens in both eyes indicating weak zonules caused by pseudoexfoliation syndrome, which was more pronounced in the left eye. Cataract surgery was performed initially in the left eye by phacoemulsification. Additionally, iris hooks and capsular tension ring (CTR) were used to stabilize the capsular bag, and the haptic of the intraocular lens (IOL) was sutured to the iris at the end of the surgery. The same procedure except haptic suturing was performed in the right eye after 6 months. The left eye remained stable, whereas the right eye developed considerable anterior capsular contraction 2 months postoperatively. Neodymium-doped yttrium aluminum garnet (Nd:YAG) laser capsulotomy was performed to treat the condition. Moreover, 3 years after the initial surgery, late IOL-CTR-capsular-bag complex dislocation developed in the right eye, and reposition surgery was performed. Three days after IOL-CTR-capsular-bag complex reposition surgery, endophthalmitis developed; the eye responded well to 1 mg intravitreal vancomycin treatment. IOL in the right eye remained stable 3 years postoperatively.

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Section: Discussionmentioning

confidence: 64%

Section: Introductionmentioning

confidence: 99%

Long-Term Outcome of Cataract Surgery in Eyes with Pseudoexfoliation Syndrome Associated with Weak Zonules: A Case Report

Vanags

Laganovska

2020

Case Rep Ophthalmol

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“…Three case reports by Kocak et al present late IOL-CTR-capsular bag dislocation at 2.5, 3, and 8 years after cataract surgery for patients with PEX syndrome-associated weak zonules. All three patients had received hydrophilic acrylic lenses and developed marked fibrosis in the anterior capsule opening and capsular bag [ 10 ]. Shingleton et al (2017) reported three cases (2%) of late IOL dislocation among 143 high-risk patients (PEX syndrome with pre- and intra-operative diagnosed zonular weakness) but did not provide the timing of the dislocation or whether CTRs had been implanted.…”

Section: Discussionmentioning

confidence: 99%

“…The reported mean time of late IOL dislocation varies from 5 to 12.5 years after the initial cataract surgery [ 1 , 2 , 3 , 4 , 6 , 9 ]. Individual case reports from complicated surgeries have reported earlier occurrence, ranging from 2.5 to 8 years [ 10 , 11 ].…”

Section: Introductionmentioning

confidence: 99%

Anterior Capsule Opening Contraction and Late Intraocular Lens Dislocation after Cataract Surgery in Patients with Weak or Partially Absent Zonular Support

2021

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Background and Objectives: To evaluate anterior capsule opening (ACO) contraction and late intraocular lens (IOL) dislocation after cataract surgery in patients with weak or partially absent zonular support and assess methods of reducing these complications. Materials and Methods: For this prospective study, we enlisted cataract surgery patients in our hospital with preoperative diagnoses of weak zonules. All patients received phacoemulsification surgery with implantation of a hydrophobic acrylic IOL and capsular tension ring (CTR). ACO reductions were measured for six months after enrolment. Data on late IOL dislocations were collected five years after enrolment of the last patient. Results: Fifty-three patients were enrolled from 2011 to 2015. Over the six-month active follow-up period, ACO area reduction was 23% in patients receiving CTRs of 11 mm diameter and 8% for patients with CTRs of 12 mm, with an overall mean of 15% reduction. Five years after the last patient was enrolled, seven patients (13%) had experienced late IOL-CTR-capsular bag dislocation. For these patients, the mean ACO reduction in the first six months of follow-up was 33%, including for those who had received neodymium-doped yttrium aluminum garnet (Nd: YAG) anterior capsulotomies. Conclusion: Use of hydrophobic acrylic lenses and CTR reduces ACO contraction, with rates comparable to those after cataract surgery without ocular comorbidity. Our patients experienced a relatively high rate of late IOL-CTR-capsular bag dislocation. However, dislocated complexes were easily repositioned and few patients required IOL exchange. Frequent visits are warranted to promptly detect late complications of cataract surgery in patients with weak zonular support.

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“…The cases of IOL dislocation are reported more frequently in recent years with the growing community of patients who has undergone cataract surgery 1 . The early IOL dislocation often occurs due to improper IOL fixation and intraoperative complications and late dislocation occurs three months or later after surgery as a result of progressive zonular weakness, capsular contraction syndrome, physical labor that causes high intraocular pressure and trauma 2 . The surgical treatment of patients with IOL dislocation includes IOL reposition and IOL replacement, but the optimal management for IOL dislocation need to be considered comprehensively 3 .…”

Section: Introductionmentioning

confidence: 99%

Repeated intraocular lens dislocation followed by haptic deformation and loss of tension: a case report

Zhou

Wen

et al. 2020

Preprint

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Background: Intraocular lens (IOL) dislocation is a rare but serious postoperative complication of intraocular lens implantation, so far, there is no report describing late intraocular lens dislocation caused by a deformed haptic piercing through the iris. Case report: A 29-year-old male developed IOL dislocation one and a half years after IOL implantation in his right eye. The eye examination showed that haptic pierced the iris at 10 o'clock in his right eye, according to intraoperative exploration, the haptic was deformed and became less elastic, the patient underwent the surgery of IOL reposition for various factors, but finally did not achieve a satisfactory outcome. Conclusion: Late IOL dislocation followed by haptic deformation is difficult to detect unless there are serious complications. When the position of IOL haptics is not in a plane with its optical surface, it should be highly vigilant that the function of the haptics may be abnormal. IOL replacement should be performed as soon as possible for the IOL dislocation caused by the loss of haptic tension.

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Spontaneous Late Intraocular Lens and Capsule Tension Ring Dislocation

Cited by 11 publications

References 23 publications

Long-Term Outcome of Cataract Surgery in Eyes with Pseudoexfoliation Syndrome Associated with Weak Zonules: A Case Report

Long-Term Outcome of Cataract Surgery in Eyes with Pseudoexfoliation Syndrome Associated with Weak Zonules: A Case Report

Anterior Capsule Opening Contraction and Late Intraocular Lens Dislocation after Cataract Surgery in Patients with Weak or Partially Absent Zonular Support

Repeated intraocular lens dislocation followed by haptic deformation and loss of tension: a case report

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