RISK FACTORS AND SURGICAL APPROACH FOR PARS PLANA VITRECTOMY OF POSTERIORLY DISLOCATED INTRAOCULAR LENSES

HM WAQAS; SS KHAN; N AADIL; M FATIMA; SHR JAFRI; A MANZOOR

doi:10.54112/bcsrj.v2023i1.272

Authors

HM WAQAS Department of Vitreo Retina, Nishter Medical University, and Hospital, Multan, Pakistan
SS KHAN Department of Ophthalmology, Bakhtawar Amin Hospital Multan, Pakistan
N AADIL Department of Ophthalmology, Nishter Medical University, and Hospital, Multan, Pakistan
M FATIMA Department of Ophthalmology, Nishter Medical University, and Hospital, Multan, Pakistan
SHR JAFRI Department of Ophthalmology, Bakhtawar Amin Medical & Dental College Multan, Pakistan
A MANZOOR Department of Vitreo Retina, Bakhtawar Amin Medical & Dental College Multan, Pakistan

DOI:

https://doi.org/10.54112/bcsrj.v2023i1.272

Keywords:

Lens Dislocation, Intraocular Lens, Pars Plana Vitrectomy

Abstract

The retrospective study was conducted in the Department of Ophthalmology, Nishtar Medical Hospital, and Bakhtawar Amin Trust Hospital from January 2022 to January 2023 to evaluate risk factors and surgical approach for posterior dislocation of the intraocular lens into vitreous requiring pars plana vitrectomy. A total of 30 eyes of 30 patients (20 male and 10 female) were included in the study. Standard PPV vitrectomy was performed in all patients. The Iris fixation technique was used in patients having a 3-piece lens design. A sclera fixation technique was performed to secure the lens and prevent it from falling onto the retina. IOL (Intra-Ocular Lens) was exchanged in eyes in which it was previously damaged. Results showed that in 28 (93.3%) eyes, the original lens was conserved and positioned on the scleral wall, iris, or both. The existing lens could not be preserved in 2(6.6%) eyes. 92.1% of cases had a single risk factor for IOL dislocation. After surgery, uncorrected visual acuity (UCVA) improved from 20/400 on the initial visit to 20/80 on the final (P=0.001). UCVA remained unchanged in 3 (10%) patients and improved in 27 (90%) patients. It can be concluded that the incidence of posterior IOL dislocation has been increasing. Intravitreal substance injections, myopia, and previous vitrectomy are the major risk factors. In most cases, the existing lens can be preserved and secured in the posterior chamber through pars plana vitrectomy.

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