title: Intraocular lens dislocation and tube shunt in the posterior chamber: a case report.
abstract: BACKGROUND
  To describe management of a case of intraocular lens (IOL) and capsular bag (CB) dislocation in an eye with an Ahmed glaucoma valve in the posterior chamber.
  
  
  METHODS
  A 75-year-old pseudophakic man with open-angle glaucoma and diabetic retinopathy developed neovascular glaucoma. After two intravitreous injections of bevacizumab and panretinal photocoagulation were administered, the new vessels regressed. However, goniosynechiae were observed over 360° of the angle. An Ahmed glaucoma valve model FP7 was implanted with the tube in the posterior chamber with adequate intraocular pressure control. Nineteen years after cataract surgery, when the IOL-CB complex became dislocated, they were sutured transclerally to the sulcus without Ahmed glaucoma valve modification. After a coughing episode, the vitreous pushed the IOL-CB complex forward and the tube was behind the IOL-CB complex. A 25-gauge posterior vitrectomy was performed, and the tube was returned to in front of the optic of the IOL using a forceps tip through a sclerotomy.
  
  
  CONCLUSIONS
  This case suggested that management of IOL-CB dislocation can modify glaucoma shunt function. A complete pars plana vitrectomy may be required in order to reposition the dislocated IOL-CB complex in the presence of a posterior chamber drainage tube implant.
authors.affiliation: Department of Ophthalmology, Clínica Universidad de Navarra, Universidad de Navarra, Avda. Pio XII, 36-31008, Pamplona, Spain. jmoreno@unav.es.
authors.forename: Javier
authors.initials: J
authors.lastname: Moreno-Montañés
authors.affiliation: Department of Ophthalmology, Clínica Universidad de Navarra, Universidad de Navarra, Avda. Pio XII, 36-31008, Pamplona, Spain. avelazquezvilloria@gmail.com.
authors.forename: Alvaro
authors.initials: A
authors.lastname: Velázquez-Villoria
authors.affiliation: Department of Ophthalmology, Clínica Universidad de Navarra, Universidad de Navarra, Avda. Pio XII, 36-31008, Pamplona, Spain. alfonso.sabater@gmail.com.
authors.forename: Alfonso L
authors.initials: AL
authors.lastname: Sabater
authors.affiliation: Department of Ophthalmology, Clínica Universidad de Navarra, Universidad de Navarra, Avda. Pio XII, 36-31008, Pamplona, Spain. asalinas@unav.es.
authors.forename: Angel
authors.initials: A
authors.lastname: Salinas-Alamán
mesh_terms: D000368:Aged; D060437:Artificial Lens Implant Migration / Q000209:etiology* / Q000601:surgery; D003930:Diabetic Retinopathy / Q000150:complications; D020327:Glaucoma Drainage Implants; D015355:Glaucoma, Neovascular / Q000601:surgery; D006801:Humans; D007429:Intraocular Pressure / Q000502:physiology; D007910:Lenses, Intraocular; D008297:Male; D057972:Posterior Eye Segment / Q000601:surgery*; D011475:Prosthesis Failure; D019591:Pseudophakia / Q000209:etiology; D012086:Reoperation; D014792:Visual Acuity / Q000502:physiology; D014821:Vitrectomy