Intraocular Lens (IOL) Dislocation Workup

Updated: May 12, 2021
  • Author: Lihteh Wu, MD; Chief Editor: John D Sheppard, Jr, MD, MMSc  more...
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Workup

Imaging Studies

If a vitreous hemorrhage or severe corneal edema is present, B-scan ultrasonic imaging should be used to determine the position of the IOL and the presence or absence of retinal detachment.

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Histologic Findings

Studies in cadaver eyes indicate that transscleral sutures must exit the sclera 0.8 mm posterior to the limbus in the vertical meridian and 0.46 mm posterior to the limbus in the horizontal meridian to be within the true ciliary sulcus.

Postmortem studies disclosed that scarring does not occur in the vicinity of the sutured IOL. The haptics are surrounded by a thin fibrous capsule at their attachment site. The transscleral portion of the suture is characterized by the lack of inflammation. In addition, the suture tip usually is exposed externally. If the fixation sutures were cut, the IOL would dislocate back into the vitreous cavity. It was concluded that the stability of the IOL was primarily a result of intact transscleral sutures and not fibrous encapsulation or ciliary sulcus placement of the haptics.

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