Prevention of Late Dislocation of the IOL in the Lens Capsule as a Stage of Anti-Glaucoma Surgery

Ivanova NV1, Savchenko AV1*, Litvinenko OA2 and Ogbonna GW3

1Department of Ophthalmology, Medical Academy Named after S.I. Georgievsky, Russia
2Department of Ophthalmology, St. Luka's Multidisciplinary Center, Medical Academy Named after S.I. Georgievsky
of Crimean Federal University, Russia
3Colchester General Hospital, UK

^*Correspondance to: Savchenko AV 

 PDF  Full Text Short Communication | Open Access

Abstract:

Patients with pseudoexfoliation syndrome after cataract phacoemulsification are at risk of delayed
dislocation of the IOL (Intraocular Lens) into the vitreous, which requires the development of
preventive measures.
Aim: Development of a surgical method for the prevention of IOL dislocation in patients with
decompensated open-angle glaucoma and zonular weakness, and analysis of its clinical, functional,
and refractive results.
Material and Methods: Our prospective, uncontrolled study included 35 patients (45 eyes) with
uncompensated pseudoexfoliation glaucoma, pseudophakia and zonular weakness with the
possibility of the Intraocular Lens - Capsular Tensor Rings – Lens Capsule (IOL-CTR-LC) complex
dislocating into the vitreous. Intraocular Pressure (IOP) higher than 28 mmHg in all patients eyes
who were on maximum antihypertensive therapy were recorded, which served as the indication for
urgent anti-glaucoma intervention, called sinus-trabeculectomy. During surgery, the position of the
IOL was stabilized by the method we propose. The observation period ranged from 6 months to 1
year.
Results and Discussion: The IOL-CTR-LC complex took a stable position in the plane of the iris in
all eyes. IOP was normal on the first day after surgery. All previously prescribed antihypertensive
drugs were stopped for all patients. Visual functions improved, fields of vision expanded, and overall
threshold sensitivity and visual acuity improved without correction in 40 eyes (88.9%).
Conclusions: The proposed method of stabilization of the IOL-CTR-LC complex, as a stage of
anti-glaucoma surgery, was effective and safe, and can be used as a novel type of surgery for the
prevention of IOL dislocation in the long term. Patients with pseudoexfoliation syndrome after
cataract phacoemulsification are at risk of delayed dislocation of the IOL into the vitreous body,
which requires the development of preventive measures.

Keywords:

Pseudophakia; Intraocular lens dislocation; Secondary glaucoma; Intraocular lens fixation; Cataract; Complications; Pseudoexfoliation syndrome; Sinus trabeculectomy

Cite the Article:

Ivanova NV, Savchenko AV, Litvinenko OA, Ogbonna GW. Prevention of Late Dislocation of the IOL in the Lens Capsule as a Stage of Anti-Glaucoma Surgery. World J Surg Surgical Res. 2020; 3: 1227..