[Removal of luxated crystalline lenses by intravitreal phaco-emulsification].

OBJECTIVE

To present the complex surgical technique used for the management of luxated crystalline lenses and to evaluate results of this treatment.

METHODS

Between May 2001 and February 2002, ten patients (ten eyes) were treated for crystalline lens luxation. There were 4 females and 6 males in this group, their age ranged between 46 and 78 years (average 63 years). In all cases, the surgical technique comprised pars plana vitrectomy, perfluorocarbon liquid injection and crystalline lens phacoemulsification in the vitreous cavity. Simultaneously, anterior chamber IOLs were implanted in 8 eyes, and scleral-fixation, posterior chamber IOLs in 2 eyes. The follow-up ranged between 1 and 9 months (mean 2.7 months).

RESULTS

All dislocated lenses were successfully removed. No complications occurred during phacofragmentation. We achieved improvement in visual acuity in 5 cases, while good pre-operative visual acuity (with aphakic correction) did not change postoperatively in remaining 5 eyes. The mean preoperative visual acuity was 0.52 (0.1-1.0), and it was 0.75 (0.2-1.0) postoperatively. In 9 cases very good visual acuity (6/6-6/12) was achieved. There were no serious complications. In the first postoperative days transient hypotonia and Descemet's membrane folds were observed in 8 eyes, fibrinous reaction in the anterior chamber in one eye, and dispersed blood in the vitreous cavity in 2 eyes.

CONCLUSIONS

The management of luxated lenses using the described method is safe. Very good functional results and lack of severe complications are very encouraging. Additional cases with a longer follow-up study are necessary to support our opinion.