Management of subluxed and dislocated intraocular lenses in patients with uveitis: a practical approach

ABSTRACT

Purpose: To describe practical approaches to the management of subluxed or dislocated intraocular lenses (IOL) in patients with uveitis.

Patients and methods: Retrospective case series from a specialist uveitis clinic

Results: Fifteen IOLs in 13 patients were subluxed inferiorly (12) or dislocated into anterior chamber (2) or vitreous (1) at a mean delay of 12 years after cataract surgery. Six eyes required vitrectomy and seven IOL explantation. A dislocated IOL was repositioned by scleral fixation in one, and a new IOL was implanted in three (two scleral-sutured, one iris-claw). Eight were observed without surgery and 7 were left functionally aphakic (4 corrected with contact lens). The mean final best-corrected visual acuity was 0.6 LogMAR.

Conclusions: There are several management choices for IOL dislocation which should take into account the degree of uveitis, patient age and expectations. We present a pragmatic approach: surgery can often be avoided in this high-risk group.

KEYWORDS:

• Uveitis
• cataract
• intraocular lens
• dislocation
• subluxation

Acknowledgments

This research was facilitated by the Greater Manchester Local Clinical Research Network.

Declaration of interest

The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.