EVALUATION OF VITRECTOMY AND REIMPLANTATION FOLLOWING LATE DISLOCATION OF THE INTRAOCULAR LENS-CAPSULAR BAG COMPLEX: A 3-Year Follow-up Study.

OBJECTIVES: To study the predisposition factors for dislocation of the intraocular lens (IOL)-capsular bag complex and analyze the results of subsequent reimplantation surgery. METHODS: The exclusion criteria were complicated cataract surgery and minor dislocations that appeared in the first year after cataract surgery. Thirty-six months of monitoring of the reimplantation surgery was required. The primary measurements of results were factors concerning dislocation, the interval between cataract surgery and dislocation, and postoperative complications. RESULTS: Thirty-six patients with dislocation of the capsular bag and lens were identified. Pseudoexfoliation was mentioned in 17 cases (47.2%) and was the main predisposition factor. The average interval between cataract surgery and dislocation was 11.5 years. The dislocated IOL was replaced by a posterior chamber implant in 38% of cases and an anterior chamber implant in 62%. The average best-corrected visual acuity improved significantly after the reposition surgery (P < 0.01). The average monitoring period after secondary reimplantation was 5.95 years (min. 3.03-max. 8.46). Three patients developed bullous keratopathy, all of them with an anterior chamber IOL implantation. CONCLUSION: According to our knowledge, this article is the one with the longest monitoring time to date. Pseudoexfoliation was the main risk factor for the dislocation of the IOL. Surgery significantly improved best-corrected visual acuity, and the reimplantation of the IOL in the posterior chamber was associated with less serious complications.

Renal cell carcinoma detected on Tc-99m-labeled red blood cell imaging.

A 61-year-old-man with persistent anemia was referred for a Tc-99m-labeled red blood cell (RBC) scan to detect any source of gastrointestinal bleeding. RBC scintigraphy revealed a hypervascular mass in the left renal fossa with functional loss in that kidney, suggesting the possibility of a renal cell carcinoma (RCC). Computed tomography confirmed this. Most RCC tumors are hypervascular on conventional angiography, with a maximum incidence in men in the sixth decade. The incidental diagnosis of RCC during radionuclide imaging has been documented in previous reports, but the authors are not aware of any case of RCC diagnosed during a RBC scan. This case illustrates the importance of careful attention to the appearance of the kidneys on radionuclide scans. Noticeable asymmetric renal activity in a patient without known renal parenchymal disease warrants further investigation.