Lin HL, Tseng GL. A spontaneous protruded angle-supported anterior chamber intraocular lens: A case report.
Medicine (Baltimore) 2019;
98:e15814. [PMID:
31145315 PMCID:
PMC6708828 DOI:
10.1097/md.0000000000015814]
[Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
RATIONALE
Anterior chamber intraocular lens (ACIOL) remains a surgical option for visual rehabilitation during complicated cataract surgeries with minimal or no capsular support. ACIOL causing scleral perforation is rare, and the involved causes remain debatable.
PATIENT CONCERNS
Here, we present the case of a 62-year-old female with spontaneous protrusion of an angle-supported ACIOL haptic tip through an extracapsular cataract extraction (ECCE) wound, who presented with progressive right-eye ptosis and right-side headache.
DIAGNOSIS
The slit lamp examination showed a vertically aligned angle-supported Kelman Multiflex ACIOL in the anterior chamber. The ACIOL had deviated upward, with upper haptic protruding from the previous ECCE scleral tunnel wound. Fundus examination and optical coherence tomography (OCT) revealed cystoid macular edema (CME) with mild epiretinal membrane (ERM).
INTERVENTIONS
The patient was treated with ACIOL extraction, pars plana vitrectomy, ERM peeling, and scleral-fixated posterior chamber IOL implantation.
OUTCOMES
Three months after surgery, the best-corrected visual acuity in the right eye improved to 20/80 and the right-side headache and hyperemia of the conjunctiva had significantly subsided. Repeated OCT revealed improved CME.
LESSONS
Poor construction of the scleral tunnel incision may cause wound dehiscence. The vertically aligned ACIOL haptic tip resting at the angle may exert stress toward the dehiscent wound, exacerbating tissue erosion and causing scleral perforation with haptic tip exposure.
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