Case report: Posterior chamber IOL dislocated into anterior chamber

PARIS — Dislocation of a posterior chamber IOL into the anterior chamber is rare but possible following uncomplicated phacoemulsification, according to a case report presented here.

In a poster at the European Society of Cataract and Refractive Surgeons, Manpreet Singh Chhabra, MD, and colleagues described the phenomenon, which occurred in a 56-year-old man who underwent uncomplicated phaco followed by IOL implantation

The IOL was a PMMA posterior chamber lens with modified-C, step-vaulted haptics. The IOL’s biconvex 5.25-mm optic had an optical power of +21 D, the authors said.

On the first postoperative day, the IOL was observed lying in the anterior chamber. Surgery was immediately performed to reposition the IOL into the capsular bag, according to the case report.

The authors said the dislocation probably occurred because one lens haptic was placed in the bag while the other was placed in the sulcus. The resulting instability of the lens, combined with the small-diameter optic and a fully dilated pupil, probably allowed the extrusion into the anterior chamber, they said.

“Ensure that both the haptics of the posterior chamber IOL are preferably both in the bag or in the sulcus at the end of surgery,” the authors said. “A fully dilated pupil, especially after inserting a small optic (5.25 mm), can be responsible for this unusual complication.”