Korean J Ophthalmol.  2004 Jun;18(1):52-57. 10.3341/kjo.2004.18.1.52.

Bilateral Spontaneous Dislocation of Intraocular Lenses within the Capsular Bag in a Retinitis Pigmentosa Patient

• Lee HJ
• Min SH
• Kim TY

• KMID: 1115784
• DOI: http://doi.org/10.3341/kjo.2004.18.1.52

Abstract

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.

Keyword

Intraocular lens dislocation; Retinitis pigmentosa; Scanning electron microscopy; Zonular weakness

MeSH Terms

Adult
Foreign-Body Migration/*etiology
Humans
Lens Capsule, Crystalline/*pathology
Lens Implantation, Intraocular
*Lenses, Intraocular
Ligaments/ultrastructure
Male
Microscopy, Electron, Scanning
Phacoemulsification
Reoperation
Retinitis Pigmentosa/*complications
Vitrectomy

Figure

• 

  Fig. 1 Fundus photograph of the right(A) and left(B) eyes. Bone-spicule pigmentation just anterior to the posterior pole with normal-appearing macula and slightly pale optic disc are evident.

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  Fig. 2 Slit lamp photograph. IOL dislocation in the right eye after pupil dilation six years after phacoemulsification can be seen.

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  Fig. 3 Scanning electron microscopy. A: The removed intraocular lens within the capsular bag in the right eye with phacoemulsification. B, C: The zonular remnants' clumps are unevenly distributed on the equator. D: There are some parts with no zonules. Equator and haptic, white arrows; continuous curvilinear capsulorhexis margin, asterisks; optic, black arrows; zonular remnants' clumps, arrowheads (A: original magnification ×22. B: original magnification ×44. C: original magnification ×178. D: original magnification ×356).

• 

  Fig. 4 Slit lamp photograph. A: A haptic has been prolapsed into the anterior chamber and the optic has been captured by the temporal iris in the left eye, but they are still in the bag. B: After pupil dilation, zonular dehiscence can be seen between the positions of 1 to 6 o'clock (white arrows).

• 

  Fig. 5 Scanning electron microscopy. The zonular remnants (arrowheads) are found more evenly distributed and densely on most of the equator (white arrows) of the capsular bag in the left eye which underwent ECCE than the right eye. (A: original magnification ×44. B: original magnification ×178. C: original magnification ×356).

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