Abstract
Purpose::
To utilize ultrasound biomicroscopy (UBM) in evaluating haptic-induced postoperative complications in psuedophakic eyes implanted with single-piece AcrySof intraocular lenses.
Methods::
Ultrasound biomicroscopy using a 50MHz transducer was performed on four pseudophakic eyes with non-infectious postoperative complications after undergoing phacoemulsification with posterior chamber intraocular lens placement. Single-piece AcrySof intraocular lenses were used in all four cases. Postoperative complications included pigment dispersion, recurrent anterior chamber hemorrhage and uveitis. Anterior segment anatomy was evaluated, including the placement of the intraocular lens haptics and the position of the lens. Views were obtained in all quadrants.
Results::
Ultrasound biomicroscopy revealed malposition of the intraocular lens in all four cases. UBM findings included haptics positioned outside of the capsular bag and touching the ciliary processes or posterior iris surface. Intraocular lens (IOL) tilting was noted in all of the cases. This was most obvious at the papillary margin where the distance of the IOL from the posterior surface of the pupil differed between equatorially diametric positions by 0.4±0.3mm.
Conclusions::
Ultrasound biomicroscopy confirmed that asymmetric single-piece AcrySof IOL placement, including IOL tilting and haptic displacement outside of the capsular bag, was the cause of postoperative complications in these cases. UBM can thus help to elucidate the cause of such postoperative complications in pseudophakic eyes, by visualizing anterior segment anatomy including the position of the intraocular lens and haptics. In such cases, localization of the lens and haptics are essential in devising a treatment plan.
Keywords: intraocular lens • treatment outcomes of cataract surgery • imaging methods (CT, FA, ICG, MRI, OCT, RTA, SLO, ultrasound)