Management of retinal detachments in pseudophakic patients with Artisan lenses.
OBJECTIVE
To report the management and outcomes of retinal detachment repair in patients with Artisan intraocular lenses (IOLs) used for pseudophakic correction.


METHODS
Two university-based referral centers.In this retrospective case-control study, all cases of retinal detachments in patients with an Artisan IOL used for pseudophakic correction were reviewed over 5 years at 2 university clinics.


RESULTS
Of the 20 patients identified, all had a detachment in 2 or more quadrants. A retinal tear was identified in 19 patients preoperatively. Thirteen patients had a standard buckling procedure, 3 with the addition of gas; 3 required a pars plana vitrectomy; and 2 were treated with pneumatic retinopexy alone. Reattachment was achieved with 1 procedure in 11 patients, with 2 procedures in 5 patients, and with 3 procedures in 3 patients; reattachment could not be achieved in 2 cases. Anterior displacement of the lens was noted when gas tamponade was used. When the displacement was significant, sodium hyaluronate 1% (Healon was used to prevent corneal endothelial touch.


CONCLUSIONS
In most cases, the Artisan lens did not significantly limit peripheral retinal visibility. Standard buckling procedures were generally successful. Given the limited support provided by the iris, the presence of gas in the vitreous cavity can lead to anterior displacement of the lens. Corneal endothelial touch can be prevented by the use of Healon, which is sufficient if short-term gas tamponade is used.
van der Meulen
Ivanka
I
Department of Ophthalmology, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands. m.d.desmet@amc.uva.nl
Gunning
Frans
F
Henry
Ype
Y
de Vries-Knoppert
Willemien
W
Gortzak-Moorstein
Nitza
N
de Smet
Marc D
MD
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016022:Case-Control Studies; D002648:Child; D003452:Cryosurgery / Q000379:methods*; D005260:Female; D006801:Humans; D006820:Hyaluronic Acid / Q000627:therapeutic use; D019654:Lens Implantation, Intraocular; D007910:Lenses, Intraocular; D008297:Male; D008875:Middle Aged; D019591:Pseudophakia / Q000150:complications*; D012163:Retinal Detachment / Q000209:etiology / Q000601:surgery*; D012167:Retinal Perforations / Q000209:etiology / Q000601:surgery; D012189:Retrospective Studies; D012591:Scleral Buckling / Q000379:methods*; D014792:Visual Acuity; D014821:Vitrectomy / Q000379:methods*
D006820:Hyaluronic Acid