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Pars plana vitrectomy for posteriorly dislocated intraocular lenses: risk factors and surgical approach

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Abstract

Purpose

To present updated risk factors, anatomical and visual outcomes and a surgical approach to posteriorly dislocated intraocular lenses (IOL).

Methods

A retrospective case series review of patients presenting with posteriorly dislocated IOL to the vitreous was performed. All cases were managed surgically with pars plana vitrectomy (PPV) followed by IOL repositioning and refixation or IOL exchange. Clinical characteristics, risk factors for IOL dislocation, visual outcomes and intraoperative and postoperative complications were investigated.

Results

Forty patients with posteriorly dislocated IOL underwent 3-port PPV and lens retrieval at an average of 6.5 years after cataract surgery. The main causes of IOL dislocation were previous PPV, myopia, pseudoexfoliation syndrome, ocular trauma and recurrent intravitreal injections. The existing IOL was repositioned and secured in 90% of the cases. Visual acuity improved in 34 patients, maintained in 5 and deteriorated in 1. All IOLs were central and stable at final follow-up.

Conclusion

Posterior intraocular lens dislocation is becoming more prevalent. The main underlying causes found in this series were previous vitrectomy, myopia and recurrent intra-vitreal substance injections. Visual acuity improved in most cases after lens repositioning; however visual outcome is often limited due to associated ocular co-morbidities despite adequate lens position. Despite complete lack of zonular support, a posteriorly dislocated IOL can often be preserved by repositioning and fixation of the lens in the posterior chamber. Pathologies primarily associated with this type of lens malposition include history of vitrectomy, high myopia and multiple intravitreal substance injections.

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Funding

This study was not funded.

Author information

Authors and Affiliations

  1. Department of Ophthalmology, Meir Medical Center (affiliated with the Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel), 59 Tchernichovsky St., 44281, Kfar Saba, Israel

    Sara Sella, Alexander Rubowitz, Shira Sheen-Ophir, Joseph R. Ferencz, Ehud I. Assia & Yokrat Ton

  2. Ein-Tal Eye Center, Tel Aviv, Israel

    Ehud I. Assia

Authors
  1. Sara Sella
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  2. Alexander Rubowitz
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  3. Shira Sheen-Ophir
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  4. Joseph R. Ferencz
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  5. Ehud I. Assia
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  6. Yokrat Ton
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Corresponding author

Correspondence to Sara Sella.

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Conflict of interest

Author Sara Sella declares that she has no conflict of interest. Author Alxendar declares that he has no conflict of interest. Author Shira Sheen-Ophir declares that she has no conflict of interest. Author Joseph R. Ferencz declares that he has no conflict of interest. Author Prof. Ehud I Assia is a consultant to Hanita Lenses, Biotechnology General, Vision Care, IOPtima, APX Ophthalmology, Visidome, CorNeat Vision. Author Yokrat Ton declares that she has no conflict of interest.

Ethical approval

Research number 0173-15 MMC was approved by IRB, Meir Medical Center, Kfar Saba Israel. As retrospective research no inform consent indicated per IRB.

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Sella, S., Rubowitz, A., Sheen-Ophir, S. et al. Pars plana vitrectomy for posteriorly dislocated intraocular lenses: risk factors and surgical approach. Int Ophthalmol 41, 221–229 (2021). https://doi.org/10.1007/s10792-020-01570-7

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  • DOI: https://doi.org/10.1007/s10792-020-01570-7

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