Modified haptic externalizing technique for repositioning dislocated 1-piece acrylic posterior chamber implants.

Abstract

To describe a novel vitreoretinal technique and the results of repositioning dislocated 1-piece acrylic posterior chamber intraocular lenses (PCIOL). This retrospective study included 7 eyes of 7 patients (ages 41 to 82) who underwent repositioning surgery with vitreoretinal methodology for dislocated 1-piece acrylic PCIOL between 2003 and 2005. Repositioning surgery involved temporary haptic externalization via anterior sclerotomies and passing curved needles of 9-0 or 10-0 polypropylene sutures through soft distal knobs of haptics before reinternalization for sulcus fixation. All 7 repositioned PCIOL remained centered and stable after 12 to 28 months of follow-up (mean = 17.6 months). Mild anterior-posterior intraocular lens (IOL)-tilting developed in 1 eye, but the IOL remained centered and secured in the sulcus with good vision. One PCIOL was exchanged with an anterior chamber intraocular lens (ACIOL) 1 year after repositioning because of recurrent intraocular hemorrhage and cystoid macular edema. Preoperative best corrected Snellen visual acuity (BCVA) ranged from 20/40 to 5/200 (median = 20/70). Postoperative BCVA ranged from 20/20 to 20/200 (median = 20/40). Capsular defect was the cause of IOL dislocation for all cases. Four of 7 eyes (57.1%) had axial myopia. This repositioning technique for dislocated all-acrylic PCIOL prevents suture slippage and allows secured sulcus fixation. Repositioned haptics should be sutured more than 1 mm from the limbus to avoid iris chafing.