[Positioning of intraocular lens haptics intentionally implanted in the ciliary sulcus by ultrasound biomicroscopy].
OBJECTIVE
To evaluate the position of haptics of intraocular lens intentionally implanted in the ciliary sulcus in eyes undergoing cataract surgery complication associated with intraoperative posterior capsule rupture, as well as to correlate the findings with clinical changes observed in ophthalmic examination, utilizing ultrasound biomicroscopy.


METHODS
Eleven eyes (11 patients) who had posterior capsule rupture during cataract surgery with intentional implantation of the haptics in the ciliary sulcus, underwent complete ophthalmic examination and ultrasound biomicroscopy. Ultrasound biomicroscopy evaluated the parameters: positioning of the distal portion of the haptics, tilt and decentration of the intraocular lens. Ophthalmic examination was aimed to evaluate the presence of flare and cells in the anterior chamber, deposits on the lens and iris transillumination defects. Intraocular pressure was measured, pigmentation of the trabecular meshwork was determined, and a fundoscopic evaluation was needed to rule out peripheral retinal rupture and macular edema.


RESULTS
Mean postoperative time for the examinations: 103.09 ± 32.93 days. Asymmetry of the haptics positioning was observed in 3 eyes (27.2%) that had one haptic in the ciliary sulcus, the second haptic was placed in the pars plana in 2 eyes, associated to intraocular lens tilt and decentration; or in the ciliary body (1 eye). Ophthalmic examination observed: 5 (45.5%) eyes with iris transillumination defects, 2 (18.1%) with intraocular lens decentration; 1 eye (9%) presented ocular hypertension. In all cases trabecular hyperpigmentation was observed at gonioscopy. No cases of peripheral retinal rupture and/or macular edema were reported.


CONCLUSIONS
Ultrasound biomicroscopy was able to locate the intraocular lens haptics intentionally implanted in the ciliary sulcus during complicated cataract surgery, and could demonstrate the relation of intraocular lens decentration to assymetric haptic implantation.
Departamento de Oftalmologia, Universidade Federal de São Paulo - UNIFESP - São Paulo (SP), Brasil.
Ricardo
R
Rau
Carmen Resende
CR
Santana
Andrea Alejandra Gonzalez
AA
Martinez
André Luiz de Freitas
AL
Silva
Norma
N
Allemann
D000368:Aged; D000369:Aged, 80 and over; D002924:Ciliary Body / Q000601:surgery*; D005260:Female; D006068:Gonioscopy; D006801:Humans; D019654:Lens Implantation, Intraocular / Q000379:methods*; D007910:Lenses, Intraocular; D008297:Male; D033401:Microscopy, Acoustic / Q000379:methods*; D008875:Middle Aged; D018918:Phacoemulsification / Q000009:adverse effects / Q000379:methods*; D057851:Posterior Capsular Rupture, Ocular / Q000209:etiology; D012016:Reference Values; D014065:Tonometry, Ocular; D016896:Treatment Outcome