Repositioning dislocated posterior chamber intraocular lenses.

PURPOSE: Removing a dislocated posterior chamber intraocular lens (IOL) is a hazardous procedure that may lead to severe complications and visual loss. A new technique for handling this complication by means of vitrectomy to help replace the luxated IOL directly in the anterior chamber is described.

METHODS: Five patients (two men and three women) underwent surgery for replacement of a luxated posterior chamber IOL in the vitreous cavity. The average age was 67.4+/-8.9 (years+/-SD); range, 57-79 years. Before and after vitrectomy, specular microscopy study of the corneal endothelium was done.

RESULTS: The results obtained in these five patients were highly satisfactory, with an average final visual acuity of 20/32 and residual refraction of -1.125+/-1.33. There was no evidence of corneal endothelium decompensation. In one patient, a retinal detachment occurred after 7 months, which was operated successfully.

CONCLUSIONS: This technique-which allows permanent, stable, and controllable replacement of an IOL with minimal trauma to the iris and corneal endothelium-avoids postoperative induced astigmatism. The technique is useful for IOL with and without positioning holes. No corneal incision is needed; the standard sclerotomies for vitrectomy are used.