title: Creeping posterior synechiae following hyperopic iris-fixated phakic implants.
abstract: The purpose of this study was to report on the occurrence and management of posterior synechiae (PS) in three hyperopic eyes after iris-fixated anterior chamber phakic IOL implantation. This is a case report of a 55-year-old man and a 55-year-old lady who had undergone iris-fixated anterior chamber phakic IOL implantation to correct hyperopic astigmatism (one eye) and hyperopia (both eyes), respectively. The three eyes developed creeping PS and pigment dispersion within 4-6 weeks of surgery. Synechiolysis and pupil stretching in one eye did not work as the synechiae promptly recurred. Definitive management in the form of removal of the phakic implant and phacoemulsification with lens implant was successful in restoring normal vision in all three eyes. Although implantation of phakic intraocular lenses has been reported to be very effective for the correction of moderate to high degrees of ametropia, this complication can occur in hyperopic eyes. Pigment dispersion has been reported in myopic eyes also, but PS seem to be more an issue with hyperopic eyes. Age of the patient may also be a factor. This information is important in the selection and counselling of patients.
authors.affiliation: Academic Section of Ophthalmology and Visual Sciences, Division of Clinical Neuroscience, University of Nottingham, Nottingham, UK.
authors.forename: Marco
authors.initials: M
authors.lastname: Messina
authors.affiliation: Academic Section of Ophthalmology and Visual Sciences, Division of Clinical Neuroscience, University of Nottingham, Nottingham, UK.
authors.forename: Mohamed
authors.initials: M
authors.lastname: Elalfy
authors.affiliation: Academic Section of Ophthalmology and Visual Sciences, Division of Clinical Neuroscience, University of Nottingham, Nottingham, UK.
authors.forename: Usama
authors.initials: U
authors.lastname: Fares
authors.affiliation: Academic Section of Ophthalmology and Visual Sciences, Division of Clinical Neuroscience, University of Nottingham, Nottingham, UK.
authors.forename: Noha
authors.initials: N
authors.lastname: Ghoz
authors.affiliation: Academic Section of Ophthalmology and Visual Sciences, Division of Clinical Neuroscience, University of Nottingham, Nottingham, UK.
authors.forename: Balraj
authors.initials: B
authors.lastname: Mavi
authors.affiliation: Academic Section of Ophthalmology and Visual Sciences, Division of Clinical Neuroscience, University of Nottingham, Nottingham, UK. harminder.dua@nottingham.ac.uk.|Department of Ophthalmology, Eye, ENT Centre, Queens Medical Centre, B Floor, Derby Road, Nottingham, NG7 2UH, UK. harminder.dua@nottingham.ac.uk.
authors.forename: Harminder
authors.initials: H
authors.lastname: Dua
mesh_terms: D005260:Female; D006801:Humans; D006956:Hyperopia / Q000601:surgery*; D007498:Iris / Q000601:surgery*; D007499:Iris Diseases / Q000209:etiology*; D019654:Lens Implantation, Intraocular / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D054120:Phakic Intraocular Lenses / Q000009:adverse effects*; D011183:Postoperative Complications / Q000473:pathology*
keywords: Iris-fixated lenses; Phakic IOL; Posterior synechia