June 2013
Volume 54, Issue 15
Free
ARVO Annual Meeting Abstract  |   June 2013
Outcomes of Transpupillary Posterior Chamber Intraocular Lens Removal with Pars Plana Vitrectomy and Placement of Anterior Chamber Intraocular Lens
Author Affiliations & Notes
  • Pavlina Kemp
    Department of Ophthalmology, University of Iowa, Iowa City, IA
  • A. Johnson
    Department of Ophthalmology, University of Iowa, Iowa City, IA
  • James Folk
    Department of Ophthalmology, University of Iowa, Iowa City, IA
  • Stephen Russell
    Department of Ophthalmology, University of Iowa, Iowa City, IA
  • Vinit Mahajan
    Department of Ophthalmology, University of Iowa, Iowa City, IA
  • H Culver Boldt
    Department of Ophthalmology, University of Iowa, Iowa City, IA
  • Thomas Oetting
    Department of Ophthalmology, University of Iowa, Iowa City, IA
  • Elliott Sohn
    Department of Ophthalmology, University of Iowa, Iowa City, IA
  • Footnotes
    Commercial Relationships Pavlina Kemp, None; A. Johnson, None; James Folk, None; Stephen Russell, IDx, LLC (I), IDx, LLC (P); Vinit Mahajan, None; H Culver Boldt, None; Thomas Oetting, None; Elliott Sohn, None
  • Footnotes
    Support None
Investigative Ophthalmology & Visual Science June 2013, Vol.54, 5774. doi:
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      Pavlina Kemp, A. Johnson, James Folk, Stephen Russell, Vinit Mahajan, H Culver Boldt, Thomas Oetting, Elliott Sohn; Outcomes of Transpupillary Posterior Chamber Intraocular Lens Removal with Pars Plana Vitrectomy and Placement of Anterior Chamber Intraocular Lens. Invest. Ophthalmol. Vis. Sci. 2013;54(15):5774.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose: To evaluate visual results, intra-operative and post-operative complications in eyes needing pars plana vitrectomy (PPV) with transpupillary posterior chamber intraocular lens (PCIOL) removal and placement of anterior chamber intraocular lens (ACIOL).

Methods: We conducted a retrospective chart review on patients who underwent PPV for dislocated PCIOL and concurrent placement of ACIOL at the University of Iowa Hospitals and Clinics from 1/1/2007 to 11/1/2012. IRB approval was obtained. Detailed pre-, intra-, and post-operative data were compiled, and statistical analysis was performed.

Results: 14 patients (5 males, 9 females) met the inclusion criteria and were analyzed. There were 8 right eyes and 6 left eyes. The mean age at time of surgery was 82.6 years (median = 82, range 74 - 92). Mean visual acuity (VA) at time of surgery was 20/225 (median = 20/250). Mean VA at final visit until 9 months post-operatively was 20/40 (median = 20/40), with mean improvement in visual acuity of 0.80 logMAR units. Intra-operative suprachoroidal hemorrhage occurred in 1 patient (7%) and post-operatively in 2 patients (14%); all resolved spontaneously; mean post-operative VA in these three patients was 20/40. There were no cases of intra-operative or post-operative choroidal detachment. Post-operatively, 5 (36%) developed cystoid macular edema; 3 (24%) had vitreous hemorrhage; 2 (14%) had hyphema; 2 (14%) developed epiretinal membrane; 2 (14%) had corneal decompensation, including one with perforation of penetrating keratoplasty graft requiring enucleation and the other with light perception vision after a detached DSAEK graft; 1 (7%) had ACIOL instability, corrected on the first post-operative day; 1 (7%) had iris capture of the ACIOL necessitating IOL exchange; 4 (28%) had no complications. There were no cases of post-operative glaucoma, uveitis-glaucoma-hyphema syndrome, or retinal detachment. Mean follow-up was 62 weeks (median = 13.5 weeks).

Conclusions: Transpupillary PCIOL removal with PPV and placement of ACIOL is in an effective procedure for improvement in VA, requiring proper management of post-operative complications. The most common post-operative complications were found to be cystoid macular edema and vitreous hemorrhage. The most detrimental complication in this series was corneal decompensation, resulting in very poor visual outcomes.

Keywords: 762 vitreoretinal surgery • 567 intraocular lens  
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