title: Vitreoretinal management of posteriorly dislocated plate haptic silicone intraocular lenses.
abstract: OBJECTIVE
  To report the vitreoretinal management of posteriorly dislocated plate haptic silicone intraocular lenses (PHSIOLs) and to present a surgical algorithm for this problem.
  
  
  METHODS
  A retrospective analysis of 12 cases of immediate and delayed posterior dislocation of a PHSIOL after phacoemulsification was performed.
  
  
  RESULTS
  The ages of the patients ranged from 26 years to 82 years (mean, 68 years); six of the patients were male. Delayed posterior dislocation of the PHSIOL occurred in 7 eyes (after Nd:YAG laser capsulotomy in 4 cases), while intraoperative dislocation occurred in 5 eyes. Defects of the anterior capsulorhexis rim or posterior capsule were present in nine eyes. The mean time from PHSIOL dislocation to definitive treatment was 4.8 months (range, 0.25-13 months). All patients underwent pars plana vitrectomy and implant exchange or repositioning. The dislocated PHSIOL was removed through the transpupillary route in 8 cases, while it was segmented and delivered through the pars plana in 3. Two patients underwent implant repositioning in the ciliary sulcus, although subsequent redislocation in one case required transpupillary removal and exchange. The mean follow-up period was 6.5 months (range, 2-18 months), with a final best corrected visual acuity of 6/12 or better in 10 eyes.
  
  
  CONCLUSIONS
  Delayed and immediate dislocation of PHSIOL can occur in eyes with a defect in capsular integrity. The implant may be repositioned or exchanged following vitrectomy with either transpupillary or pars plana removal, resulting in generally excellent postoperative visual acuity and minimal complications.
authors.affiliation: Vitreoretinal Research Unit, Moorfields Eye Hospital, London, United Kingdom.
authors.forename: Dipak N
authors.initials: DN
authors.lastname: Parmar
authors.forename: Andres
authors.initials: A
authors.lastname: Kychenthal
authors.forename: Eric
authors.initials: E
authors.lastname: Ezra
authors.forename: G William
authors.initials: GW
authors.lastname: Aylward
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000465:Algorithms; D005260:Female; D005548:Foreign-Body Migration / Q000601:surgery*; D006801:Humans; D007431:Intraoperative Complications / Q000601:surgery*; D007910:Lenses, Intraocular; D008297:Male; D008875:Middle Aged; D018918:Phacoemulsification; D011183:Postoperative Complications / Q000601:surgery*; D012086:Reoperation; D012189:Retrospective Studies; D012826:Silicone Elastomers; D014792:Visual Acuity; D014821:Vitrectomy
chemical_list: D012826:Silicone Elastomers