Pars plana vitrectomy and iris suture fixation of posteriorly dislocated intraocular lenses.
OBJECTIVE
To describe the outcomes of combined pars plana vitrectomy (PPV) and iris suture fixation of posteriorly dislocated intraocular lenses (IOLs).


METHODS
Tertiary academic referral center.


METHODS
Retrospective noncomparative consecutive case series.


METHODS
The included eyes had posteriorly dislocated IOLs and had combined PPV and iris suture fixation. The IOL dislocations amenable to surgical repair with an anterior approach were excluded. Outcome measures included improvement in corrected distance visual acuity (CDVA), induction of astigmatism, and complications.


RESULTS
This study consisted of 27 consecutive cases. The mean follow-up was 6.61 months ± 8.1 (SD). The median postoperative CDVA was 20/30, and 16 of 27 eyes had stable or improved CDVA compared with baseline; 8 of the others had a shift from aphakic to pseudophakic correction. Overall, a significant myopic shift in spherical equivalent occurred after surgery, from 7.62 ± 4.38 diopters (D) to -1.33 ± 1.45 D (P < .001). Surgically induced astigmatism (SIA) assessed by comparing the difference in preoperative keratometry readings with the difference in postoperative manifest refraction cylinder adjusted to the corneal plane gave the following: 1.89 ± 1.09 D versus 1.13 ± 0.86 D, respectively (P < .001). All IOLs were stable and centered at the last follow-up; however, 1 was mildly tilted. One eye had a recurrent subluxation, and the IOL was resutured before the end of the study. No cases of endophthalmitis or retinal detachment occurred.


CONCLUSIONS
Combined PPV and iris suture fixation of posteriorly dislocated IOLs led to stable fixation of the IOLs.


BACKGROUND
No author has a financial or proprietary interest in any material or method mentioned.
From the Cornea Division (Soiberman, Stark) and the Retina Division (Gehlbach), Wilmer Eye Institute, Johns Hopkins University School of Medicine, and the Department of Biostatistics (Murakami), School of Public Health, Johns Hopkins University, Baltimore, Maryland, USA.
Uri
U
Soiberman
From the Cornea Division (Soiberman, Stark) and the Retina Division (Gehlbach), Wilmer Eye Institute, Johns Hopkins University School of Medicine, and the Department of Biostatistics (Murakami), School of Public Health, Johns Hopkins University, Baltimore, Maryland, USA.
Peter L
PL
Gehlbach
From the Cornea Division (Soiberman, Stark) and the Retina Division (Gehlbach), Wilmer Eye Institute, Johns Hopkins University School of Medicine, and the Department of Biostatistics (Murakami), School of Public Health, Johns Hopkins University, Baltimore, Maryland, USA.
Peter
P
Murakami
From the Cornea Division (Soiberman, Stark) and the Retina Division (Gehlbach), Wilmer Eye Institute, Johns Hopkins University School of Medicine, and the Department of Biostatistics (Murakami), School of Public Health, Johns Hopkins University, Baltimore, Maryland, USA. Electronic address: wstark@jhmi.edu.
Walter J
WJ
Stark
D000368:Aged; D000369:Aged, 80 and over; D060437:Artificial Lens Implant Migration / Q000503:physiopathology / Q000601:surgery*; D001251:Astigmatism / Q000503:physiopathology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007431:Intraoperative Complications; D007498:Iris / Q000601:surgery*; D019654:Lens Implantation, Intraocular / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009216:Myopia / Q000503:physiopathology; D012189:Retrospective Studies; D013536:Suture Techniques; D014792:Visual Acuity / Q000502:physiology; D014821:Vitrectomy / Q000379:methods*