Cases reported "Foreign-Body Migration"

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1/18. Complications of endocapsular tension ring implantation in a child with Marfan's syndrome.

    A 4-year-old boy with Marfan's syndrome had severe visual impairment after subluxation of the crystalline lens with bisection of the pupil. In the first eye, a capsular tension ring and an intraocular lens (IOL) were uneventfully placed in the capsular bag after phacoemulsification. During implantation of the endocapsular tension ring in the second eye, an inadvertent tear of the anterior capsule occurred, and the posterior chamber IOL was placed in the sulcus. In both eyes, severe lens epithelial proliferation with secondary IOL decentration developed postoperatively. Several surgical revisions were necessary to keep the IOL within the optical axis. In the eye with the sulcus-implanted IOL, the endocapsular tension ring was markedly decentered.
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ranking = 1
keywords = phacoemulsification
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2/18. Posterior dislocation of a plate-haptic silicone intraocular lens with large fixation holes.

    We present a patient who had uneventful phacoemulsification with in-the- bag implantation of a silicone plate-haptic posterior chamber intraocula r lens (IOL) with 1.15 mm fixation holes. Six months after a neodymium: YAG laser capsulotomy, the IOL spontaneously dislocated posteriorly. A pars plana vitrectomy was performed, the IOL was explanted, and a 3-piece loop-haptic IOL was implanted in the ciliary sulcus. Eight weeks after surgery, best corrected visual acuity was 20/20.
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ranking = 1
keywords = phacoemulsification
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3/18. Posterior capsule tear with plate-haptic silicone intraocular lens dislocation.

    We report a case of posterior capsule rupture and posterior dislocation of an intraocular lens (IOL) caused by the tip of a silicone plate-haptic lens. The dislocation occurred during IOL implantation after uneventful phacoemulsification in a patient with a small pupil. Discussed are the possible reasons for the complication and measures to prevent it.
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ranking = 1
keywords = phacoemulsification
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4/18. Spontaneous luxation of encapsulated intraocular lens onto the retina after a triple procedure of vitrectomy, phacoemulsification, and intraocular lens implantation.

    PURPOSE: To report the clinical and histological findings of a luxated intraocular lens (IOL) in the capsular bag. methods: review of a case. RESULTS: Twenty-three months after a triple procedure of vitrectomy, phacoemulsification, and IOL implantation for diabetic vitreous hemorrhage and cataract, the encapsulated IOL spontaneously luxated. Scanning electron microscopy showed sparsely distributed anterior and equatorial zonules, with only a few posterior zonules on the surface of the removed capusular bag. CONCLUSION: The absence of the anterior hyaloid membrane and posterior zonules and contraction of the lens capsule may cause dialysis of the zonules. Therefore, the anterior hyaloid membrane should be left in place in patients at low risk for the development of postoperative proliferation to maintain the long-term stability of the IOL.
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ranking = 5
keywords = phacoemulsification
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5/18. Early decentration of plate-haptic silicone intraocular lenses.

    We report 4 eyes of a consecutive series of 1299 that developed early decentration of a 10.5 mm diameter plate-haptic silicone intraocular lens (IOL) after uneventful phacoemulsification. All eyes had an intact continuous curvilinear capsulorhexis (CCC) with the IOL placed in the capsular bag. After an initial period of good vision, patients noted the onset of glare or monocular diplopia between 1 and 5 weeks after surgery. On examination, there was no significant anterior capsule contraction; however, the edge of the IOL optic was visible in the undilated pupil. There was adhesion between the anterior and posterior capsules at the margin of the CCC that maintained the IOL decentration. Decentration recurred in 1 eye after the IOL was rotated 90 degrees and recentered. Symptoms resolved in 3 eyes after the IOL was removed and replaced with a rigid IOL with a larger diameter optic.
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keywords = phacoemulsification
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6/18. Intraocular lens subluxation in a patient with facial atopic dermatitis.

    A 66-year-old Japanese man presented with subluxation of a posterior chamber intraocular lens (IOL) caused by a rupture of part of Zinn's zonule but no retinal break 2 years after phacoemulsification with IOL implantation. He had a history of atopic dermatitis since infancy. This case presents a rare ocular complication of scratching and rubbing the face and eyelids because of itching related to atopic dermatitis.
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ranking = 1
keywords = phacoemulsification
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7/18. Vitreoretinal management of posteriorly dislocated plate haptic silicone intraocular lenses.

    PURPOSE: To report the vitreoretinal management of posteriorly dislocated plate haptic silicone intraocular lenses (PHSIOLs) and to present a surgical algorithm for this problem. methods: A retrospective analysis of 12 cases of immediate and delayed posterior dislocation of a PHSIOL after phacoemulsification was performed. RESULTS: The ages of the patients ranged from 26 years to 82 years (mean, 68 years); six of the patients were male. Delayed posterior dislocation of the PHSIOL occurred in 7 eyes (after Nd:YAG laser capsulotomy in 4 cases), while intraoperative dislocation occurred in 5 eyes. Defects of the anterior capsulorhexis rim or posterior capsule were present in nine eyes. The mean time from PHSIOL dislocation to definitive treatment was 4.8 months (range, 0.25-13 months). All patients underwent pars plana vitrectomy and implant exchange or repositioning. The dislocated PHSIOL was removed through the transpupillary route in 8 cases, while it was segmented and delivered through the pars plana in 3. Two patients underwent implant repositioning in the ciliary sulcus, although subsequent redislocation in one case required transpupillary removal and exchange. The mean follow-up period was 6.5 months (range, 2-18 months), with a final best corrected visual acuity of 6/12 or better in 10 eyes. CONCLUSIONS: Delayed and immediate dislocation of PHSIOL can occur in eyes with a defect in capsular integrity. The implant may be repositioned or exchanged following vitrectomy with either transpupillary or pars plana removal, resulting in generally excellent postoperative visual acuity and minimal complications.
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ranking = 1
keywords = phacoemulsification
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8/18. Late complications with intraocular lens dislocation after capsulorhexis in pseudoexfoliation syndrome.

    We report 3 cases of significant late intraocular lens/capsular bag subluxation after uneventful capsulorhexis, endolenticular phacoemulsification, and capsular bag implantation in patients with pseudoexfoliation syndrome.
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ranking = 1
keywords = phacoemulsification
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9/18. Long-term complications of bilateral posterior chamber phakic intraocular lens implantation.

    A 34-year-old woman had posterior chamber phakic intraocular lens (PCP IOL) implantation to correct high myopia in both eyes. Five years postoperatively, the patient presented with a decrease in visual acuity from central anterior subcapsular cataract formation in both eyes and IOL dislocation in the left eye. In vivo confocal microscopy of the cornea showed markedly decreased endothelial cell density in both eyes and the presence of bright endothelial microdeposits possibly related to pigmentary dispersion. gonioscopy showed angle pigmentary deposits with no intraocular pressure increase. The patient was successfully treated by removing the PCP IOLs and performing phacoemulsification with in-the-bag IOL implantation in both eyes. This led to a recovery of visual acuity. This case report presents the rare occurrence and surgical management of cataract formation, IOL dislocation, and severe endothelial cell loss as a late complication of PCP IOL implantation.
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ranking = 1
keywords = phacoemulsification
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10/18. Bilateral spontaneous dislocation of intraocular lenses within the capsular bag in a retinitis pigmentosa patient.

    A 45-year-old man with retinitis pigmentosa (RP), who had undergone uneventful extracapsular cataract extraction (ECCE) in his right eye eight years previously, and phacoemulsification in his left eye six years previously, had spontaneously dislocated intraocular lenses (IOL) within the capsular bag in both eyes one month apart. We removed the dislocated IOLs, and performed anterior vitrectomy and scleral fixation of the new IOLs. Mild contraction of the capsular bags and uneven distribution of the zonular remnants' clumps along the equator of the capsules were found by scanning electron microscopic (SEM) examination. In this study, we propose the correlation between RP and zonular weakness. To our knowledge, this is the first case report of bilateral spontaneous dislocation of IOLs within the capsular bag of an RP patient.
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ranking = 1
keywords = phacoemulsification
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