Silicone Posterior Chamber Phakic Intraocular Lens Dislocated into the Vitreous Cavity

Abstract

PURPOSE: To report two highly myopic patients with silicone posterior chamber phakic intraocular lenses (Phakic Refractive Lens; CIBA Vision, Duluth, Ga) that luxated into the vitreous cavity without history of ocular trauma. METHODS: Two patients with posterior chamber phakic intraocular lenses (PIOLs) that luxated into the vitreous cavity of the right eye were examined. Each eye underwent pars plana vitrectomy and removal of the posterior chamber PIOL under retrobulbar anesthesia. RESULTS: Both patients were treated successfully. In the first patient, the posterior chamber PIOL luxated into the anterior vitreous cavity whereas in the second patient, the posterior chamber PIOL lay on the posterior pole. No ocular complications developed postoperatively. CONCLUSION: Luxation into the vitreous cavity is a rare, but potentially severe complication of posterior chamber PIOL refractive surgery in highly myopic eyes. Successful management includes pars plana vitrectomy and removal of the posterior chamber PIOL. [J Refract Surg 2004;20:773-777]

Long-term Results of Phakic Refractive Lens Implantation in Eyes With High Myopia

“…No eye experienced luxation in the vitreous. Dislocation of the PRL in the vitreous cavity is a potentially severe complication, [20][21][22] which can occur in high myopes, especially in cases with previous unrecognized ocular trauma or intraoperative manipulations resulting in spontaneous PRL decentration. The cases reported in the literature suggest that PRL rotation causes excess pressure against the zonules.…”

“…The cases reported in the literature suggest that PRL rotation causes excess pressure against the zonules. [20][21][22] Pars plana vitrectomy and removal of the PRL are essential to manage this serious complication.…”

Long-term Complications of Posterior Chamber Phakic Refractive Lenses: Case Report and Literature Review

“…Masoud Soheilian (15) USA 2012 1 Bilateral uveitis ICL Partially dislocated into Espinosa-Mattar Z (16) Mexico 2012 1 the anterior chamber and ICL corneal decompensation In Ki Park (12) Korea 2008 1 Recurrent occlusion of ICL laser iridotomy sites Rafaek Navarro (17) Spain 2005 1 Bilateral Giant Retinal Tear ICL Vicente Martinez-Castillo (2) Spain 2004 2 Dislocated into the vitreous ICL cavity Haralabos Eleftheriadis (18) Spain 2004 1 Spontaneous dislocation into PRL the vitreous cavity Smallman DS (19) Canada 2004 1 Pupillary block glaucoma PRL Kodjikian L (20) France 2002 1 Malignant glaucoma ICL César A Sáńchez-Galeana (10) Mexico 2002 1 Pigmentary glaucoma with ICL refractory IOL increase James D Brandt (5) USA 2001 1 Induced Pigmentary ICL dispersion syndrome *First author; PC: posterior chamber; pIOL: phakic intraocular lens; PRL: phakic refractive lens; ICL: implantable collamer lens…”

“…Implantation of intraocular lenses in the phakic eye (pIOL) is a relatively new technique to correct high ametropias (1). In 2001, implantation of posterior chamber (PC) pIOL known as the Phakic refractive lens was reported (2). In our institution, we started to implant the PRL (Baikang surgical, Chekiang, China) which was made of silicone to treat high myopia.…”

“…The phalic refractive lens has proven to be a safe and effective procedure to correct moderate to high myopia in most eyes (3). Because of the proximity of the PRL to the crystalline lens, complications of PRL implantation such as cataract formation, endothelial cell loss (4), pigmentary glaucoma (5), pupillary block (6,7) and dislocation into the vitreous cavity (2) had been reported, and the rate of complications was expected to increase with time. Nevertheless, to the best of our knowledge, there has been no previous case report on PRL long-term complication in China.…”