Vitreous luxated PC-IOLs: complications

Abstract

Purpose: To determine pre-, intra- and postoperative complications of posterior chamber intraocular lenses (PC-IOL) posteriorly luxated in the vitreous.

Methods: We retrospectively reviewed reports of all patients with luxated PC-IOLs at our institution (1989-1999) with a minimum follow-up of 6 months. We identified 41 eyes; 4 were excluded because of short follow-up. Thirty-seven eyes were finally considered. Twenty-one eyes had "in situ" repositioning with vitrectomy, in 9 of them perfluorocarbon liquids (Perfluoro-DK-line) (PFCL) were used to refloat the luxated lenses. Sixteen eyes had IOL exchange, in 7 of them PFCL was used to refloat the IOL.

Results: The average age of the patients was 67.5 years. Preoperatively, 15 eyes (40%) had ocular hypertension, 9 eyes (24%) showed epithelial corneal edema (CE), 6 eyes (16%) had light vitreous hemorrhage (VH) and 4 eyes (11%) retinal detachment (RD). Intraoperatively, 9 eyes (24%) had VH related to sulcus fixation. Postoperatively, visual acuity improved in 32 (86%) eyes. In 3 cases (8%) we found a postsurgical RD that could be iatrogenic; one eye developed glaucoma and 1 developed, epiretinal membrane. Two patients were PFCL drops.

Conclusion: Vitrectomy normalizes IOP and CE, PFCL simplifies the surgical technique for RD, and sulcus fixated IOL allows visual restoration. The combined technique generally offers good results.