Operating microscope light-induced phototoxic maculopathy after transscleral sutured posterior chamber intraocular lens implantation.
OBJECTIVE
The purpose of this study is to report the features of operating microscope light-induced retinal phototoxic maculopathy after transscleral sutured posterior chamber intraocular lens (TSS PC-IOL) implantation.


METHODS
The charts of 118 patients who underwent TSS PC-IOL implantation surgery at Chonbuk National University Hospital (Jeonju, Korea) between March 1999 and February 2008 were retrospectively reviewed. Fourteen patients underwent combined 3-port pars plana vitrectomy and TSS PC-IOL implantation (vitrectomy group), and 104 patients underwent TSS PC-IOL implantation only (nonvitrectomy group). All surgeries were performed under the same coaxial illuminated microscope. All diagnoses were confirmed through careful fundus examination and fluorescein angiography (FA).


RESULTS
Diagnoses of retinal phototoxic maculopathy were established in 10 (8.47%) of 118 TSS PC-IOL implantation cases. Phototoxic maculopathy occurred more frequently in the vitrectomy group than in the nonvitrectomy group (6/14 versus 4/104, respectively; P < 0.001, chi-square = 24.21). Affected patients reported decreased vision and were found to have coarse alterations of the retinal pigment epithelium (RPE). In 5 of the phototoxic maculopathy cases (50%), the visual acuity was 20/200 or worse.


CONCLUSIONS
Operating microscope light-induced retinal phototoxic maculopathy can occur more frequently after TSS PC-IOL implantation than after casual cataract surgery, especially when TSS PC-IOL is combined with vitrectomy surgery. Surgeons should take precautions to prevent retinal phototoxicity after TSS PC-IOL implantation and vitrectomy.
Kweon
Eui Yong
EY
Department of Ophthalmology, Chonbuk National University Medical School, Jeonju, South Korea.
Ahn
Min
M
Lee
Dong Wook
DW
You
In Cheon
IC
Kim
Min Jung
MJ
Cho
Nam Chun
NC
D000328:Adult; D000368:Aged; D005260:Female; D005451:Fluorescein Angiography; D006801:Humans; D007049:Iatrogenic Disease; D019654:Lens Implantation, Intraocular; D008027:Light / Q000009:adverse effects*; D008297:Male; D008853:Microscopy / Q000295:instrumentation*; D008875:Middle Aged; D011832:Radiation Injuries / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology; D012160:Retina / Q000528:radiation effects*; D012162:Retinal Degeneration / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology; D012590:Sclera / Q000601:surgery*; D013536:Suture Techniques; D013997:Time Factors; D014792:Visual Acuity / Q000502:physiology; D014821:Vitrectomy