Ocular co-morbidities and management outcomes in posteriorly dislocated crystalline lens and intra ocular lens

Abstract

Aim: To evaluate the associated ocular morbidity and management outcomes in posteriorly dislocated crystalline lens and intraocular lens. Methods: A retrospective study including sixty-eight eyes of patients presenting with dislocated lens and IOLs from January 2012 to May 2014 at the retina clinic were enrolled. Associated features, surgical approaches and postoperative visual outcomes were studied. Results: Fifty three eyes (78%) had dislocated crystalline lens, 15(22%) had dislocated IOL. Anterior segment features in lens and IOL group include sphincter tears (82%,0%), corneal edema (40%, 100%), secondary glaucoma (22%,9%), hyphaema (18%,0%), angle recession (5%,0%) vitreous in pupillary area (30%,100%), surgical wound gape (0%,13%). Posterior segment features include vitreous haemorrhage (11%,13%), rhegmatogenous retinal detachments (9%,13%), retained intraocular foreign body (1%,0%) respectively. In the lens group, Pars plana vitrectomy(PPV) + lensectomy was done in 84%, lensectomy+ anterior vitrectomy 15%, combined with trabeculectomy 1%, IOFB removal 1%. In IOL group, PPV + IOL explanation was done in all the eyes. Scleral fixated IOL was done in 30% and 80%, PPV+ silicone oil implantation in 6% and 13% eyes with RRD in the lens and IOL group respectively. At 3 months postop, best corrected visual acuity (BCVA )> 20/40 was seen in 70% eyes of lens group and 75.5% of IOL group with scleral fixated lens. Conclusion: Ocular co-morbidities and poor visual results are more common with dislocated crystalline lens than dislocated IOLs. Key words: Dislocated lens, Dislocated IOL, Ocular comorbidities, Management outcomes