Abstract
Abstract: :
Purpose: To report the outcome and complications associated with intraocular lens exchange using a modified McCannel–type iris–fixation of a posterior chamber lens through a small clear corneal incision for the management of symptomatic subluxed posterior chamber intraocular lenses. Methods: Retrospective review of all patients at the Wilmer Eye Institute that underwent an intraocular lens exchange using a modified McCannel–type iris–fixation technique suture fixation of a posterior chamber intraocular lens by the same surgeon (WJS). This surgical technique, performed through a small clear corneal incision, included folding the subluxed lens prior to explantation, two point iris–fixation using a modified McCannel–type fixation of a posterior chamber intraocular lens, and a pars plana vitrectomy. The final best–corrected visual acuity, refractive outcome, and any intra–operative or post–operative complications were reviewed. Results: A total of 19 cases were reviewed. The average age of the cases was 69.5 years–of–age, including 12 male and 7 female patients. The follow–up range is 3 to 24 months. The final best–corrected visual acuity was 20/40 or better in 14 of 19 cases. No patient lost 2 or more lines of vision. The refractive outcome was within 1 Diopter of predicted in 16 of 19 cases. There were no intraoperative complications. Complications were reported in two cases post–operatively. One case was found to develop choroidal detachments associated with peri–orbital pain. It resolved completely over the course of several weeks with a final best–corrected visual acuity of 20/25. The other complication reported at the 1 week post–operative period was a subluxed lens inferiorly displaced. This was attributed to a slipped knot involving the superior modified McCannel suture. The suture was revised without complication, with a final best–corrected visual acuity of 20/40. Conclusions: This surgical technique is a viable alternative to scleral or pars plana suture fixation of posterior chamber intraocular lens in cases of IOL exchange for the management of displaced posterior chamber intraocular lenses.
Keywords: clinical (human) or epidemiologic studies: outcomes/complications • treatment outcomes of cataract surgery