Clinical Ophthalmology (Oct 2021)

1 Year Surgical Outcomes and Safety of Combined Trans Pars Plana Vitrectomy with Iris Fixated Posterior Chamber Intraocular Lens for Subluxated Intraocular Lens and Cataracts

  • Foo VHX,
  • Bong TSH,
  • Tsai A,
  • Lim LS,
  • Perera SA

Journal volume & issue
Vol. Volume 15
pp. 4049 – 4057

Abstract

Read online

Valencia Hui Xian Foo,1 Tiffany Sin Hui Bong,1 Andrew Tsai,1,2 Laurence Shen Lim,1,2 Shamira Asith Perera1,2 1Department of Ophthalmology, Singapore Eye Research Institute, Singapore National Eye Centre, Singapore; 2Eye-Academic Clinical Program, Duke-NUS Medical School, National University of Singapore, SingaporeCorrespondence: Shamira Asith PereraSingapore National Eye Centre, 11 Third Hospital Avenue, 168751, SingaporeTel +65 6227 7255Fax +65 62263 995Email [email protected]/Background: To describe the characteristics and 1-year postoperative surgical outcomes of primary combined trans pars plana vitrectomy (TPPV) with iris-fixated posterior-chamber intraocular lens (IF-PCIOL) implantation for subluxated cataracts and intraocular lenses (IOLs).Methods: Consecutive cases of significantly subluxated cataracts and IOLs from January 2014 to May 2019 were included in this retrospective case series.Results: A total of 103 eyes of 103 patients were included. Median age was 67.4 (interquartile range [IQR] 27– 89) years. Thirty-two (31.1%) had subluxated cataracts, while 71 (68.9%) had subluxated IOLs. Overall median preoperative logMAR BCVA was 0.9 (IQR 0– 2.5). Median logMAR BCVA improved to 0.3 (0– 1.9) and 0.2 (0– 1.8) for the subluxated cataract and IOL groups, 81.2% and 75% of eyes achieved logMAR ≤ 0.3, and 94% and 97% achieved IOL stability at month 12, respectively. Eyes with subluxated IOLs had a significantly less myopic median SE if a new IOL was implanted compared to iris-fixating the dislocated IOL.Conclusion: Combined primary TPPV and IF-PCIOL implantation is a good surgical option for subluxated IOL or cataract without sufficient capsular support, with at least 75% achieving logMAR BCVA ≤ 0.3 and 95% IOL stability at postoperative year 1. In eyes with subluxated IOLs, explanting that IOL and iris-fixating a new IOL led to a reduced SE and better visual outcome at postoperative month 12 when compared to iris-fixating the dislocated IOL.Keywords: subluxated cataracts, subluxated intraocular lenses, secondary intraocular lens fixation, iris-fixation, trans pars plana vitrectomy

Keywords