Cameron Nathaniel W, Karadaghy Amin, Mitchell Mary K, Ajlan Radwan S
Department of Ophthalmology, University of Kansas Medical Center, Kansas City, KS, United States.
J Surg Case Rep. 2023 Nov 10;2023(11):rjad600. doi: 10.1093/jscr/rjad600. eCollection 2023 Nov.
Lens dislocation is a significant complication after cataract surgery. Scleral fixation of 3-piece intraocular lens provides favorable visual outcome and can spare patients the need for lens exchange. Two patients presented with dislocated 3-piece lenses implanted over 10 years earlier. Both patients underwent pars plana vitrectomy and dropped lens rescue with scleral fixation. Postoperatively, the lens optic was found flipped nearly 90° at the optic-haptic junctions secondary to fluid-air exchange performed during vitrectomy. Both patients underwent intraocular lens exchange with a four point sclera fixated lens. Our study found that air tamponade is better avoided during rescue of old dislocated 3-piece lens implants. Intraocular lens exchange is preferred, when possible, to avoid complications associated with old dislocated lenses. Larger studies are needed to determine the effect of time on dislocated lens implants materials.
晶状体脱位是白内障手术后的一种严重并发症。三件式人工晶状体的巩膜固定术可提供良好的视觉效果，并且可以避免患者进行晶状体置换。两名患者出现了10多年前植入的三件式晶状体脱位。两名患者均接受了玻璃体切除术和平坦部晶状体挽救及巩膜固定术。术后发现，由于玻璃体切除术中进行的液气交换，晶状体光学部在光学-襻交界处翻转了近90°。两名患者均接受了四点巩膜固定人工晶状体的眼内晶状体置换。我们的研究发现，在挽救陈旧性脱位的三件式晶状体植入物时，最好避免使用空气填塞。尽可能优先进行眼内晶状体置换，以避免与陈旧性脱位晶状体相关的并发症。需要进行更大规模的研究来确定时间对脱位晶状体植入物材料的影响。
