SURGICAL-MANAGEMENT OF POSTERIORLY DISLOCATED SILICONE PLATE HAPTIC INTRAOCULAR LENSES

PURPOSE: To report a large series of delayed posterior dislocation of silicone plate haptic intraocular lenses after Nd:YAG laser capsulotom y and discuss the surgical management of this complication. METHODS: W e reviewed the records of 11 consecutive patients (11 eyes) with delay ed onset of posterior dislocation of a plate haptic silicone intraocul ar lens. The cause of the posterior capsular defect, time to dislocati on, surgical management techniques, complications, and visual outcome were recorded. RESULTS: In eight of the 11 eyes, the silicone plate ha ptic intraocular lens dislocated an average of 1.8 months (range, 0 to 6.5 months) after Nd:YAG posterior capsulotomy. The other three eyes had surgical complications at the time of cataract extraction that com promised posterior capsular or zonular integrity and led to silicone p late haptic intraocular lens dislocation from 9 weeks to 6 months (mea n, 3.6 months) postoperatively. Surgical management consisted of pars plana vitrectomy with intraocular lens repositioning (six eyes) or exc hange (five eyes). The average follow-up period after intraocular lens repositioning or exchange was 6.5 months (range, 1 to 14 months). Bes t-corrected visual acuity at the last follow-up examination measured 2 0/40 or better in all but one eye that had preexisting macular disease . CONCLUSIONS: Cataract surgeons and patients should be aware of the p otential for plate haptic silicone intraocular lenses to undergo delay ed posterior dislocation through capsular defects, This complication c an be managed effectively with vitrectomy and either repositioning or exchange of the implant. Postoperative visual acuity is generally exce llent, and complications are minimal.