Clinical Evaluation of Intravitreal Manipulation on Posteriorly Dislocated Crystalline Lens with Intact Capsule

ABSTRACT

To evaluate the efficacy and safety of intravitreally removing the crystalline lens completely dislocated into the vitreous cavity with intact capsule, we reviewed the patients undergone pars plana vitrectomy for the treatment of intravitreal crystalline lens. The crystalline lenses were spontaneously dislocated in 4 and traumatically dislocated in 10 of all 14 eyes. Combined ocular conditions were 10 eyes of cataract, 5 of vitreous hemorrhage, 5 of increased intraocular pressure (IOP) and 2 of iridodialysis. All 14 eyes had undergone pars plana vitrectomy, intravitreal removal of the crystalline lens and scleral fixation of the intraocular lens whereas 3 had undergone trabeculectomy, 2 retinal cryopexy and injection of sulfur hexafluoride intraocular gas, and 1 iridoplasty. The lens was aspirated only with vitrectomy cutter in 1 eye; phacofragmentor was used in 13 eyes and perfluorocarbone liquid was injected in 5 eyes. Mean follow-up time was 7.42 months. On the last follow-up, visual acuity was 0.5 or better in 11 eyes and counting fingers in 1 eye with optic nerve atrophy. Retinal detachment was never found, and increased IOP sustained in 1 eye. The result suggests intravitreal removal of the crystalline lens combined with pars plana vitrectomy seems effective and safe.