Opaque intraocular lens implantation: a case series and lessons learnt

Abstract

Purpose: To report the use of opaque intraocular devices in three patients with complex neuro-ophthalmic symptoms.

Methods: A case series of three patients with neuro-ophthalmic symptoms requiring occlusion of one eye when alternative methods had failed to control symptoms. Morcher (Stuttgart, Germany) opaque intraocular implants were used in all patients.

Results: All three patients observed an improvement in symptoms following opaque intraocular device implantation. One patient (Case 2) required multiple devices for symptom relief.

Conclusion: Opaque intraocular occlusive devices are an increasingly popular choice for clinicians in patients with intractable diplopia but we highlight their use in patients with other complex neuro-ophthalmic symptoms. We learned a number of useful lessons in these patients as summarized in this case series.

Keywords: diplopia implant; intraocular lens; occlusive IOL; occlusive intraocular lens; opaque IOL.

Figure 1

Opaque intraocular lens insertion during several different procedures of Case 2: (A) Insertion of a Morcher (type 80D) opaque intraocular lens into the lens capsular bag through a scleral tunnel incision; (B) Following the second operation of Case 2, there was still a visible gap between the dual castellated rings and the central black intraocular lens, allowing a crescent of red reflex to show; (C) Custom-made black implant of 10 mm “optic” diameter being inserted into the eye.