Fixation of Subluxated Intraocular Lens
Cataract surgery is the most common operation performed by ophthalmologists. Although it has a very high success rate, certain complications may occur. Intraocular lens (IOL) malpositions range from simple IOL decentration to luxation into the posterior segment. Subluxated IOLs involve such extreme decentration that the IOL optic covers only a small fraction of the pupillary space. Luxation involves total dislocation of the IOL into the posterior segment. Decentration of an IOL may be the result of the original surgical placement of the lens, or it may develop in the postoperative period because of external (eg, trauma, eye rubbing) or internal forces (eg, scarring, peripheral anterior synechiae [PAS], capsular contraction, size disparity). Posterior dislocation of an intraocular lens (IOL) is an uncommon complication of cataract surgery and Nd:YAG posterior capsulotomy.
- Visual acuity can be compromised by optical aberrations and refractive changes. Slit lamp examination usually does not reveal evidence of inflammation unless contact of a portion of the IOL with the cornea or vitreous prolapse is present.
- Corneal edema from IOL or vitreous touch can be found. In these cases, CME may be a complication.
- Vitreous traction can increase the risk of a retinal detachment, while vitreous to the wound can be implicated in endophthalmitis.
- The posterior capsule usually has an obvious defect.
- Zonular dialysis may be present.
- The IOL may be freely mobile in the vitreous cavity; it may be in apparent contact with the retina; or it may have one haptic attached to the posterior capsule, iris, or ciliary body.