Modified haptic externalizing technique for repositioning dislocated 1-piece acrylic posterior chamber implants.
BACKGROUND
To describe a novel vitreoretinal technique and the results of repositioning dislocated 1-piece acrylic posterior chamber intraocular lenses (PCIOL).


METHODS
This retrospective study included 7 eyes of 7 patients (ages 41 to 82) who underwent repositioning surgery with vitreoretinal methodology for dislocated 1-piece acrylic PCIOL between 2003 and 2005. Repositioning surgery involved temporary haptic externalization via anterior sclerotomies and passing curved needles of 9-0 or 10-0 polypropylene sutures through soft distal knobs of haptics before reinternalization for sulcus fixation.


RESULTS
All 7 repositioned PCIOL remained centered and stable after 12 to 28 months of follow-up (mean = 17.6 months). Mild anterior-posterior intraocular lens (IOL)-tilting developed in 1 eye, but the IOL remained centered and secured in the sulcus with good vision. One PCIOL was exchanged with an anterior chamber intraocular lens (ACIOL) 1 year after repositioning because of recurrent intraocular hemorrhage and cystoid macular edema. Preoperative best corrected Snellen visual acuity (BCVA) ranged from 20/40 to 5/200 (median = 20/70). Postoperative BCVA ranged from 20/20 to 20/200 (median = 20/40). Capsular defect was the cause of IOL dislocation for all cases. Four of 7 eyes (57.1%) had axial myopia.


CONCLUSIONS
This repositioning technique for dislocated all-acrylic PCIOL prevents suture slippage and allows secured sulcus fixation. Repositioned haptics should be sutured more than 1 mm from the limbus to avoid iris chafing.
Chan
Clement K
CK
Southern California Desert Retinal Consultants, Medical Corporation, Palm springs, CA, USA. pschan@aol.com
Hawkins
Harold
H
Lin
Steven G
SG
D000179:Acrylates; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005548:Foreign-Body Migration / Q000601:surgery*; D006801:Humans; D019654:Lens Implantation, Intraocular / Q000379:methods*; D007910:Lenses, Intraocular; D008297:Male; D008875:Middle Aged; D018918:Phacoemulsification; D010865:Pilot Projects; D012086:Reoperation; D012189:Retrospective Studies; D013536:Suture Techniques; D014792:Visual Acuity
D000179:Acrylates