Faculty Collaboration Database

Combined pars plana lensectomy-vitrectomy with open-loop flexible anterior chamber intraocular lens (AC IOL) implantation for subluxated lenses. Trans Am Ophthalmol Soc 2000;98:247-51; discussion 251-3

Date

02/24/2001

Pubmed ID

11190027

Pubmed Central ID

PMC1298230

Scopus ID

2-s2.0-0034522541 (requires institutional sign-in at Scopus site)   41 Citations

Abstract

OBJECTIVES: To review our experience with combined pars plana lensectomy-vitrectomy and open-loop flexible anterior chamber intraocular lens (AC IOL) implantation for managing subluxated crystalline lenses.

METHODS: Retrospective review of 36 consecutive eyes (28 patients), all of which had subluxated crystalline lenses, managed by pars plana lensectomy-vitrectomy with insertion of an open-loop flexible AC IOL. The study was performed at the Medical College of Wisconsin, Milwaukee, over an 8-year period.

RESULTS: An average preoperative visual acuity of 20/163 (range, 20/25 to hand motions) improved to 20/36 (range, 20/20 to 4/200) with surgery after a mean follow-up of 14 months (range, 1 to 59 months) (P < .001, Student's paired t test). Final visual acuity of 20/40 or better was achieved in 75% of eyes (27/36). Complications included cystoid macular edema (8% [3/36]), pupillary block (6% [2/36]), retinal detachment (3% [1/36]), hyphema (3% [1/36]), wound leak (3% [1/36]), and transient vitreous hemorrhage (3% [1/36]). No persistent ocular hypertension was seen, nor did angle abnormalities or corneal decompensation develop.

CONCLUSIONS: Pars plana lensectomy-vitrectomy with AC IOL implantation appears to be an excellent technique for managing subluxated crystalline lenses. It is associated with a significant improvement in visual acuity (P < .001) and avoids many of the complications seen with extraction of a subluxated lens through a limbal wound. Additionally, use of an AC IOL offers a simplified alternative to placement of a ciliary sulcus sutured posterior chamber intraocular lens (PC IOL).

Author List

Kazemi S, Wirostko WJ, Sinha S, Mieler WF, Koenig SB, Sheth BP

Authors

Bhavna P. Sheth MD Professor in the Ophthalmology and Visual Sciences department at Medical College of Wisconsin
William Wirostko MD Professor in the Ophthalmology and Visual Sciences department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Adolescent
Adult
Aged
Aged, 80 and over
Anterior Chamber
Exfoliation Syndrome
Eye Injuries
Female
Humans
Lens Subluxation
Lens, Crystalline
Lenses, Intraocular
Male
Marfan Syndrome
Middle Aged
Postoperative Complications
Postoperative Period
Retrospective Studies
Visual Acuity
Vitrectomy