Removal of luxated lens fragments from the vitreous body following secondary IOL implantation along with ‘’ab externa’’ transcleral fixation

Author: Gulnar Zhurgumbayeva (Kazakhstan)

Co-authors: Dastan Kyrykbayev, Marfuga Oteuliyeva

Purpose

To evaluate the effectiveness of luxated lens fragments removal from the vitreous body by performing vitrectomy with secondary IOL implantation following transcleral fixation.

Setting/Venue

1) A 70 y.o. patient with the diagnosis: OS – Post-operative luxation of lens fragments into the vitreous body. POAG II on ocular hypotensive therapy. Phakogenic uveitis. Pseudoexfoliative syndrome. 2) Surgery: Removal of luxated lens fragments from the vitreous body following secondary IOL implantation along with ‘’ab externa’’ transcleral fixation. 3) Limited liability partnership «Kazakh Order «Badge of Honor» Research Institute of Eye Diseases»

Methods

A 70 y.o. patient was admitted to the clinic with the following diagnosis: OS – Post-operative luxation of lens fragments into the vitreous body. POAG II on ocular hypotensive therapy. Phakogenic uveitis. Pseudoexfoliative syndrome. VIS = 20/650 ( 0.03 ) IOP = 44.2 mm Hg HPI: A month ago, patient was admitted to the surgery OS – phacoemulsification with an IOL implantation after which he has developed post-op complications. Based on the operation protocol, lens fragments were pushed posteriorly to the anterior segment of vitreous body due to posterior capsular rupture. 25G vitrectomy with secondary IOL implantation following ‘’ab externa’’ transcleral fixation was performed.

Results

Surgery and postoperative period were without complications. Post-op day 1 VIS = 20/50. IOP = 18 mm Hg ( on Timolol ). IOL in correct position with TSF at 3 and 9 o'clock. Partial avitria.

Conlusions

1) Vitrectomy with secondary IOL implantation following ‘’ab externa’’ transcleral fixation is an effective method for removing the luxated lens fragments from the vitreous body. 2) It is necessary to correctly evaluate the state of the suspensory ligaments of the lens in patients with PES to avoid possible iatrogenic complications during surgery.

Financial Disclosure

Research Institutes Kazakh Order "Badge of Honor" Scientific Research Institute of Eye Diseases - place of work