Haptic breakage after transscleral fixation of a single-piece acrylic intraocular lens

Abstract

Purpose: To report the case of a patient with a damaged haptic of an acrylic intraocular lens (IOL) after transscleral IOL fixation.

Methods: This is a retrospective and descriptive case report.

Results: A 40-year-old man presented with sudden visual loss in the left eye. He had undergone phacoemulsification/aspiration and IOL implantation 3 years previously and IOL repositioning with transscleral fixation 2 years before the initial visit. His visual acuity was 0.3 in the left eye due to corneal edema caused by a foreign body, i.e., the severed haptic tip of the single-piece acrylic IOL, which was surgically removed. The IOL itself was tilted and therefore explanted. The surface of the tip of the haptic suggested that the monofilament suture thread had exerted continuous force across the haptic.

Conclusions: The haptics of acrylic IOLs can be damaged after transscleral fixation.

Keywords: Acrylic intraocular lens; Intraocular lens; Intraocular lens damage; Transscleral fixation.

Fig. 1

Anterior segment findings at the initial examination. a, b Slit-lamp examination shows a foreign body (arrow) through the prominent corneal stromal edema from 2 to 7 o'clock in the LE. Lineal depigmentation is observed at 12 o'clock in the iris. c The foreign body (arrow) observed by gonioscopy is thought to be a tip of a single-piece acrylic IOL.

Fig. 2

Microscopic observations of the extracted IOL (AcrySof SA60AT). a The damaged site (arrow) is slightly proximal to the optic compared to the opposite sutured point, resulting in failure to be fixated at the greatest diameter of the IOL. b The surface of the severed portion is relatively flat and smooth. Numerous tiny fissures are seen, which developed due to the continuous force of the suture thread. c A monofilament suture thread (arrow) adheres to the proximal aspect of the severed haptic.