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N.J. Rudometkin, E.L. Thomas, R.E. Roeske, R.N. Fabricant; Long Term Safety and Efficacy of Repositioning Dislocated Plate Haptic Intraocular Lenses in the Ciliary Sulcus . Invest. Ophthalmol. Vis. Sci. 2003;44(13):261.
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© ARVO (1962-2015); The Authors (2016-present)
Purpose: To report safety and efficacy outcomes of repositioning posterior dislocated plate haptic lenses (PHL) into the ciliary sulcus (CS). Methods: Sixteen consecutive eyes with posterior dislocated PHL that were repositioned in the CS over a 7.5-year period were reviewed retrospectively. Pars plana vitrectomy was required in the majority of cases (13) with initial repositioning in the anterior chamber prior to placement in the CS. Best corrected visual acuity (BCVA) before and after repositioning, final visual acuity, centration, length of follow-up, lens size, age of patient, apparent cause of dislocation, and concurrent eye disease are reported. Results: All lenses remained centered in the CS at an average of 22.1 months (range 1 to 92 months) of follow-up. BCVA of 20/40 or better was attained in 93.8% (15/16) of eyes. Final BCVA of 20/40 or better was observed in 68.8% (11/16) after the 22.1 months of follow-up and the decline in vision for the remaining five patients was attributable to chronic eye diseases (age related macular degeneration and diabetes). A YAG laser capsulotomy was identified as a probable cause for dislocation in 11 of 16 eyes, the other five dislocations had no obvious cause. Small anterior capsulotomies and prominent anterior capsular remnants were a common finding. The dislocation occurred at an average of 18.8 months (standard deviation 16.4) after implantation. Chronic iritis, lens "propellering&rsquotdbl;, iris chaffing or atrophy and redislocation were not encountered in this series. Conclusion: Many techniques for managing posterior dislocated lens have been described including lens exchange, scleral suture-fixation, and repositioning. Traditionally, the subset of PHLs lenses have been exchanged after dislocation because of presumed lack of stability when placed in the CS. Our study reports dislocated PHLs can be managed safely and effectively by placement in the CS with long term stability. No significant sequellae and good visual acuities were obtained commensurate with underlying retinal diseases. We recommend dislocated PHL be repositioned in the CS as the primary procedure in these cases.
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