Abstract
Purpose :
The standard treatment for anterior crystalline lens dislocation is surgical. In the acute setting, surgical complications can occur at higher rates. We describe an effective technique for in-office lens repositioning capable of avoiding or postponing the need for surgical intervention.
Methods :
A retrospective review of patients with spontaneous or traumatic anterior crystalline lens dislocation who underwent in-office lens repositioning technique was performed, identifying a case series of four patients. Outcome measures after repositioning included intraocular pressure, visual acuity, slit lamp and B-scan ultrasonography findings before and after repositioning, and ultimate need for surgery.
Results :
Four patients with acute anterior dislocation of the crystalline lens underwent in-office lens repositioning. The repositioning technique consisted of supine patient positioning, gentle pressure with a cotton tip on the peripheral cornea to guide the lens into the posterior chamber, and the use of a miotic agent afterwards to prevent subsequent subluxation. In the four cases described, the in-office technique successfully restored the lens to the posterior chamber, improved vision, and decreased intraocular pressure, in most instances by resolving the angle closure secondary to pupillary block. Three patients ultimately underwent planned surgeries to remove and/or replace the lens, and one patient was lost to follow up.
Conclusions :
We describe an in-office lens repositioning technique that can be used as an acute non-surgical intervention and/or temporizing measure for anterior crystalline lens dislocation, resulting in improved vision and normalization of intraocular pressure.
This abstract was presented at the 2024 ARVO Annual Meeting, held in Seattle, WA, May 5-9, 2024.