REPOSITIONING DISLOCATED POSTERIOR CHAMBER INTRAOCULAR LENSES

Purpose: Removing a dislocated posterior chamber intraocular lens (IOL ) is a hazardous procedure that may lead to severe complications and v isual loss. A new technique for handling this complication by means of vitrectomy to help replace the luxated IOL directly in the anterior c hamber is described. Methods: Five patients (two men and three women) underwent surgery for replacement of a luxated posterior chamber IOL i n the vitreous cavity. The average age was 67.4 +/- 8.9 (years +/- SD) ; range, 57-79 years. Before and after vitrectomy, specular microscopy study of the corneal endothelium was done. Results: The results obtai ned in these five patients were highly satisfactory, with an average f inal visual acuity of 20/32 and residual refraction of -1.125 +/- 1.33 . There was no evidence of corneal endothelium decompensation. In one patient, a retinal detachment occurred after 7 months, which was opera ted successfully. Conclusions: This technique-which allows permanent, stable, and controllable replacement of an IOL with minimal trauma to the iris and corneal endothelium-avoids postoperative induced astigmat ism. The technique is useful for IOL with and without positioning hole s; No corneal incision is needed; the standard sclerotomies for vitrec tomy are used.