Management of late in-the-bag IOL dislocation with exchange and scleral fixation of IOL with the transfixion technique

Pineda-Fernández A.A.; Chen Y. · JCRS Online Case Reports (2022) · DOI: 10.1097/j.jcro.0000000000000068

Resumen

Introduction:Late in-the-bag intraocular lens (IOL) dislocation is a serious complication of cataract surgery.Patient and clinical findings:A 70-year-old woman with a history of left eye cataract surgery presented with progressively decreasing vision that had worsened over the past 6 months. In the left eye, the uncorrected distance visual acuity (UDVA) was counting fingers at 5 m, the corrected distance visual acuity (CDVA) was 20/25 (+12.25 -1.25 × 180), and the intraocular pressure was normal. An anterior segment examination revealed severe inferior dislocation of the IOL-capsular bag complex.Diagnosis, intervention, and outcomes:The patient was diagnosed with late in-the-bag IOL dislocation and underwent IOL-capsular bag complex explantation with sulcus-sutured IOL implantation using a new scleral fixation technique that included transfixion of a foldable acrylic IOL with polytetrafluoroethylene suture. The postoperative outcome was good; the UDVA was 20/70, and the CDVA was 20/25, and there were no postoperative complications such as infection, suture erosion, iritis, uveitis, vitreous hemorrhage, or retinal detachment.Conclusions:Late in-the-bag IOL dislocation was safely managed with IOL-capsular bag complex explantation and scleral fixation of a foldable posterior chamber IOL. This transfixion technique can be used for scleral fixation in patients with late in-the-bag IOL dislocation.