Results of surgical treatment of IOL dislocation

Purpose. The analysis of clinical results in the replacement of dislocated posterior chamber IOL with capsular bag (CB) to the iridovitreal IOL RSP-3 (Russia) via a scleral-corneal tunnel incision.Material and methods. The study included 26 patients (26 pseudophakic eyes) with a dislocation of the IOL capsular bag (CB) complex after the previously performed phacoemulsification (PE), who underwent a removal of IOL with CB through a scleral-corneal tunnel incision with the following implantation of irido-vitreal IOL RSP-3.Besides the standard examination, the patients underwent a corneal endothelium count test before operation, at discharge, 1, 6 and 12 months later.Results. The dislocated IOL occupied from 20 to 50% of the pupil area causing complaints on a low visual acuity (VA), ineffectiveness of spectacle correction and binocular or monocular diplopia.All operations passed uneventfully. The early postoperative period was non-reactive in the majority of cases.It was possible intraoperatively to preserve a stable depth of anterior chamber using viscoelastic Discovisc (Alcon), thus, avoiding a rupture of anterior hyaloid membrane of vitreous body and damage of corneal endothelium.The best corrected VA (BCVA) increased from 0.32±0.05 to 0.81±0.1 in the dynamics of postoperative period, induced astigmatism indexes decreased in the absence of negative dynamics of endothelium cell density (the loss of corneal endothelium cells averaged 4.7% from the initial level).Conclusion. The used surgical method of replacement of the dislocated IOL-CB complex after the PE of senile cataract to the iridovitreal IOL RSP-3 via the scleral-corneal tunnel minimizes the risks of intra- and post-operative complications. The advantages of this technology are the safety, low indexes of induced corneal astigmatism, and high and stable visual effect.