Subluxation of iris-sutured intraocular lenses and results of a closed chamber technique for repositioning after penetrating keratoplasty.
OBJECTIVE
To describe subluxation of iris-fixated intraocular lenses (IOLs) after penetrating keratoplasty (PK) as a postoperative complication and report the long-term outcomes of a closed-chamber refixation technique used in the management.


METHODS
This was a retrospective, noncomparative interventional case series in which 19 consecutive patient charts with a subluxated iris-fixated IOL after PK were retrospectively reviewed. Fourteen of the patients underwent surgery using a closed-chamber refixation technique. These patients were evaluated for visual outcome and surgical complications associated with the procedure.


RESULTS
In 13 patients, postoperative follow-up was available. In all 13 cases, the fixated IOL appeared stable and remained well positioned during a follow-up period of 56 months (range, 6-122). All patients (100%) achieved improved uncorrected visual acuity. The postoperative visual acuity ranged from 20/20 to 20/100 with a mean of 20/40. Vitreous hemorrhage occurred in 1 patient, and an additional patient required a second surgery using the same technique. Both of these patients did well with a final visual acuity of 20/40 and 20/50, respectively.


CONCLUSIONS
Subluxation of iris-fixated IOL after PK can occur as a postoperative complication. The technique that we herein describe enables secure refixation of subluxated IOLs and yields favorable long-term results.
Jabbur
Nada S
NS
Cornea, Anterior Segment, and Refractive Surgery Service, The Wilmer Eye Institute, Johns Hopkins School of Medicine, Baltimore, MD, USA. nsjabbur@jhmi.edu
Akpek
Esen Karamursel
EK
Stark
Walter J
WJ
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D007498:Iris / Q000601:surgery*; D015948:Keratoplasty, Penetrating; D007906:Lens Subluxation / Q000601:surgery*; D007910:Lenses, Intraocular; D008297:Male; D008875:Middle Aged; D013508:Ophthalmologic Surgical Procedures; D012086:Reoperation; D012189:Retrospective Studies; D013537:Sutures; D016896:Treatment Outcome; D014792:Visual Acuity