Recurrent Vitreous Hemorrhage Secondary to Sulcus Positioning of a One-Piece Acrylic Intraocular Lens Haptic: Report of 3 Cases and Management With Retrocapsular Haptic Repositioning

Abstract

Three pseudophakic patients presented with recurrent, unilateral vitreous hemorrhage, one of which also had uveitis, glaucoma, and hyphema, consistent with "uveitis-glaucoma-hyphema (UGH)-Plus" syndrome. Arcuate transillumination defects secondary to inadvertent placement of 1 intraocular lens (IOL) haptic in the sulcus were identified in each case. The second haptic and optic were located in the capsular bag. The IOLs were all single-piece foldable acrylic lenses with square-edge haptic design. Surgical repositioning of the malpositioned haptic from the sulcus to the retrocapsular space resulted in the resolution of the recurrent vitreous hemorrhage. This series highlights the fact that recurrent vitreous hemorrhage secondary to iris chafing, with or without UGH, may occur in cases where a square-edge IOL haptic is placed in the sulcus. Vitrectomy with repositioning of the malpositioned IOL is a simple alternative to IOL exchange in these cases.

Navigating the Options for the Treatment of Intraocular Lens Malposition

“…We have recently reported good outcomes with vitrectomy and repositioning of the existing IOL into the capsular bag (Figure 4) (Supplemental Video available at www.healio.com/ OSLIRetina). 8 In some cases, enlargement of the bag is required to allow the capsular opening to be slightly smaller than the diameter of the optic. This approach of capsular capture and vitrectomy to treat UGH-plus is effective, transconjunctival, and does not require IOL exchange.…”