J Korean Ophthalmol Soc > Volume 59(7); 2018 > Article
Journal of the Korean Ophthalmological Society 2018;59(7):657-664.
DOI: https://doi.org/10.3341/jkos.2018.59.7.657    Published online July 15, 2018.
Clinical Outcomes of Combined Vitrectomy and Intrascleral Fixation of New Intraocular Lenses in In-the-bag Dislocations.
Min Soo Lee, Sue Hey Chae, Chan Woo Bang, Hye Min Jeon, Hee Seong Yoon
Sungmo Eye Hospital, Busan, Korea. heesyoon@dreamwiz.com
인공수정체 낭내 탈구에서 시행된 유리체절제술 및 새로운 인공수정체 공막내고정술의 임상 결과
이민수⋅채수혜⋅방찬우⋅전혜민⋅윤희성
성모안과병원
Correspondence:  Hee Seong Yoon,
Email: heesyoon@dreamwiz.com
Received: 14 February 2018   • Revised: 9 May 2018   • Accepted: 22 June 2018
Abstract
PURPOSE
To investigate the clinical outcomes of combined vitrectomy and intrascleral fixation of a new posterior chamber intraocular lens (PC IOL) as a treatment for IOL dislocation. METHODS: We conducted a retrospective interventional study at our medical facility from January 2015 to January 2017. Posteriorly dislocated IOLs were removed with pars plana vitrectomy. Two intrascleral tunnels, 2.0 mm in length, were created 1.5 mm to the limbus at 6 and 12 o'clock positions. Both haptics of new foldable acrylic 3-piece IOLs were inserted into the tunnel until the IOL was secured in a central position. We analyzed the preexisting ocular condition, visual acuity (VA), and refractive error preoperatively and postoperatively, and recorded postoperative complications. RESULTS: Forty-nine patients (50 eyes) were enrolled in the study. The mean follow-up period was 12.8 ± 6.6 months. A best-corrected VA of 6/12 or better was achieved in 43 eyes (86%). The mean VA significantly improved from 0.32 logarithm of the minimum angle of resolution (logMAR) at baseline to 0.18 logMAR at last follow-up (p = 0.03). The refractive status after intrascleral fixation of the PC IOL revealed a mean hyperopic shift of +1.09 ± 1.28 diopters from the predicted spherical equivalent. Postoperative vitreous hemorrhages occurred in six cases and were cleared without visual compromise. Cystoid macular edema was well-controlled by topical nonsteroidal anti-inflammatory drugs (NSAID) medications in two cases. In two cases, IOL dislocation recurred and required re-operation. There were no serious adverse events of suture-related complications, retinal detachment, corneal compromise, or endophthalmitis in any of the patients. CONCLUSIONS: Our data revealed that use of combined vitrectomy and intrascleral fixation of PC IOLs is a safe and efficient technique to correct IOL dislocation. We observed good visual outcomes with only minor complications.
Key Words: Intraocular lens dislocation;Intrascleral fixation;Pars plana vitrectomy;Posterior chamber intraocular lens


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