Management of posteriorly dislocated posterior chamber intraocular lenses by vitrectomy and pars plana removal.

PURPOSE: To report a large series of eyes in which there was a posterior dislocation of a posterior chamber intraocular lens (PCIOL). During vitrectomy, the dislocated intraocular lens (IOL) was removed through an enlarged pars plana sclerotomy. An anterior chamber IOL (ACIOL) was implanted primarily or secondarily.

METHODS: We conducted a retrospective chart review of 59 eyes of 58 patients with posterior dislocation of a PCIOL.

RESULTS: Fifty-four eyes (92%) had improved visual acuity after surgery. Sixty-six percent (39 of 59) of eyes achieved at least 20/40 vision; 25% (15 of 59) of eyes achieved a visual acuity of 20/50 to 20/200; and 8% (5 of 59) of eyes achieved less than 20/200 vision. In 32 (54%) eyes, PCIOL removal was combined with primary implantation of an ACIOL. In 27 (46%) eyes, the PCIOL was removed and the referring ophthalmologist placed a secondary ACIOL. Intraoperative complications consisted of limited suprachoroidal hemorrhage in 2 (3%) eyes. Postoperative complications consisted of retinal detachment in 5 (8%) eyes, cystoid macular edema in 13 (22%) eyes, and vitreous hemorrhage in 3 (5%) eyes.

CONCLUSION: Posterior dislocation of a PCIOL may be managed safely by removal of the dislocated PCIOL through the pars plana.