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Posterior chamber IOL dislocation safely managed with vitrectomy, exchange

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Posterior dislocation of a posterior chamber IOL was managed safely in a large series of eyes by vitrectomy and exchange with an anterior chamber IOL, a group of surgeons reports.

Robert L. Steinmetz, MD, and colleagues reviewed the charts of 59 eyes of 58 patients with posterior dislocation of a posterior chamber IOL. In these eyes, the IOLs were removed during vitrectomy through an enlarged pars plana sclerotomy. An anterior chamber IOL was implanted either at the time of vitrectomy or secondarily.

Of the 59 eyes, 54 had improved visual acuity after surgery. Thirty-nine eyes (66%) achieved at least 20/40 VA, 15 eyes (25%) achieved a VA between 20/50 and 20/200, and five eyes (8%) had a final VA of less than 20/200.

In 32 eyes, IOL removal was combined with anterior chamber IOL implantation. In 27 eyes, the posterior chamber IOL was removed during vitrectomy and the referring ophthalmologist placed the IOL secondarily.

The most common postoperative complication was cystoid macular edema, which occurred in 13 eyes (22%).

The study is published in the August issue of Retina.