Surgical management of posteriorly dislocated silicone plate haptic intraocular lenses.
OBJECTIVE
To report a large series of delayed posterior dislocation of silicone plate haptic intraocular lenses after Nd:YAG laser capsulotomy and discuss the surgical management of this complication.


METHODS
We reviewed the records of 11 consecutive patients (11 eyes) with delayed onset of posterior dislocation of a plate haptic silicone intraocular lens. The cause of the posterior capsular defect, time to dislocation, surgical management techniques, complications, and visual outcome were recorded.


RESULTS
In eight of the 11 eyes, the silicone plate haptic intraocular lens dislocated an average of 1.8 months (range, 0 to 6.5 months) after Nd:YAG posterior capsulotomy. The other three eyes had surgical complications at the time of cataract extraction that compromised posterior capsular or zonular integrity and led to silicone plate haptic intraocular lens dislocation from 9 weeks to 6 months (mean, 3.6 months) postoperatively. Surgical management consisted of pars plana vitrectomy with intraocular lens repositioning (six eyes) or exchange (five eyes). The average follow-up period after intraocular lens repositioning or exchange was 6.5 months (range, 1 to 14 months). Best-corrected visual acuity at the last follow-up examination measured 20/40 or better in all but one eye that had preexisting macular disease.


CONCLUSIONS
Cataract surgeons and patients should be aware of the potential for plate haptic silicone intraocular lenses to undergo delayed posterior dislocation through capsular defects. This complication can be managed effectively with vitrectomy and either repositioning or exchange of the implant. Postoperative visual acuity is generally excellent, and complications are minimal.
Schneiderman
T E
TE
Department of Ophthalmology, W.K. Kellogg Eye Center, University of Michigan School of Medicine, Ann Arbor, USA.
Johnson
M W
MW
Smiddy
W E
WE
Flynn
H W
HW
Bennett
S R
SR
Cantrill
H L
HL
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005500:Follow-Up Studies; D005548:Foreign-Body Migration / Q000209:etiology / Q000601:surgery*; D006801:Humans; D053685:Laser Therapy / Q000009:adverse effects; D007903:Lens Capsule, Crystalline / Q000601:surgery; D007910:Lenses, Intraocular; D008297:Male; D018918:Phacoemulsification; D011183:Postoperative Complications / Q000601:surgery*; D012086:Reoperation; D012189:Retrospective Studies; D012826:Silicone Elastomers; D014792:Visual Acuity; D014821:Vitrectomy
D012826:Silicone Elastomers