Anterior Chamber Intraocular Lens Exposure through Prelimbal Sclera: a Case Report
Journal of Ophthalmic and Optometric Sciences,
Vol. 2 No. 2 (2018),
3 Farvardin 2018
,
Page 35-40
https://doi.org/10.22037/joos.v2i2.29324
Abstract
Purpose: To report a case of spontaneous exposure of anterior chamber intraocular lens in a patient with history of congenital cataract surgery ten years prior to presentation.
Report of the case: A 27-year-old man presented with a two-year history of blurred vision, photophobia, mild ocular pain and redness in his left eye, with no history of prolonged eye rubbing, ocular surface disease or any evidence of trauma. On exam there was redness and swelling of the eyelids in the involved side; however, there was no evidence of any long standing ocular surface condition. Slit-lamp biomicroscopy disclosed an injected eye with haptic exposure of an angle-supported anterior chamber lens approximately 1 mm posterior to the limbus through the sclera. Anterior chamber was mildly inflamed and pupil was peaked towards the area of the exposed haptic. Ultrasound biomicroscopy revealed edematous and thickened sclera near the exposed tip. The dislocated lens was extracted and an iris-fixated anterior chamber lens was implanted instead. According to the size of the IOL and the white to white distance of the patient, it seemed that an incorrect selection of IOL size was the reason for the haptic exposure.
Conclusion: We presented a rare case of spontaneous anterior chamber lens exposure and its surgical management in a patient with an otherwise healthy ocular surface. It was concluded that an error in IOL size selection might have been the cause of spontaneous haptic exposure.
Key words: Lenses; Intraocular; Anterior chamber; Sclera.
How to Cite
References
Auffarth GU, Wesendahl TA, Brown SJ, Apple DJ. Are there acceptable anterior chamber intraocular lenses for clinical use in the 1990s? An analysis of 4104 explanted anterior chamber intraocular lenses. Ophthalmology. 1994;101(12):1913-22.
Sawada T, Kimura W, Kimura T, Suga H, Ohte A, Yamanishi S, et al. Long-term follow-up of primary anterior chamber intraocular lens implantation. J Cataract Refract Surg. 1998;24(11):1515-20.
Kumar A, Nainiwal SK, Dada T, Ray M. Subconjunctival dislocation of an anterior chamber intraocular lens. Ophthalmic Surg Lasers. 2002;33(4):319-20.
Smith PW, Wong SK, Stark WJ, Gottsch JD, Terry AC, Bonham RD. Complications of semiflexible, closed-loop anterior chamber intraocular lenses. Arch Ophthalmol. 1987;105(1):52-7.
Gungel H, Altan C, Baylancicek DO. Endophthalmitis due to exposure of anterior chamber intraocular lens haptic tip. J Cataract Refract Surg. 2009;35(9):1633-6.
Rong X, Lu Y. Spontaneous exposure of angle-supported anterior chamber intraocular lens haptic tip. J Cataract Refract Surg. 2016;4(1):1-4.
Lin HL, Tseng GL. A spontaneous protruded angle-supported anterior chamber intraocular lens: A case report. Medicine (Baltimore). 2019;98(22):e15814.
Spierer O, O'Brien TP. Spontaneous Scleral Perforation of an Anterior Chamber Intraocular Lens. Case Rep Ophthalmol. 2016 9;7(1):249-52.
Biedner B, Rothkoff L, Blumenthal M. Subconjunctival dislocation of intraocular lens implant. Am J Ophthalmol. 1977;84(2):265-6.
Apple DJ, Brems RN, Park RB, Norman DK, Hansen SO, Tetz MR, et al. Anterior chamber lenses. Part I: Complications and pathology and a review of designs. J Cataract Refract Surg. 1987;13(2):157-74.
Apple DJ, Hansen SO, Richards SC, Ellis GW, Kavka-Van Norman D, Tetz MR, et al. Anterior chamber lenses. Part II: A laboratory study. J Cataract Refract Surg. 1987;13(2):175-89.
Fintelmann RE, Kim SK, Hwang DG. Upside-down lens syndrome: ocular complications secondary to inverted implantation of the Kelman Multiflex anterior chamber intraocular lens. Am J Ophthalmol. 2011;152(1):122-5.
Drolsum L. Long-term follow-up of secondary flexible, open-loop, anterior chamber intraocular lenses. J Cataract Refract Surg. 2003;29(3):498-503.
- Abstract Viewed: 250 times
- PDF Downloaded: 78 times