J Korean Ophthalmol Soc.  2013 Jun;54(6):966-970. 10.3341/jkos.2013.54.6.966.

Reinsertion of the Anterior Chamber Intraocular Lens with Long-Term Protruded Haptic

• Kim M
• Hyung S

• KMID: 2217276
• DOI: http://doi.org/10.3341/jkos.2013.54.6.966

Abstract

PURPOSE
To report a case of anterior chamber intraocular lens (ACL) reposition with the haptic protruded into the subconjunctiva in a patient with a previous ACL implantation.
CASE SUMMARY
A 64-year-old man visited our clinic because of visual disturbance and discomfort in his right eye. Approximately 8 years earlier, he had cataract surgery and there was no visual improvement but eye discomfort. The haptic of the ACL protruded into the subconjunctiva at 11-1 o'clock. The visual acuity of the right eye was 0.2 and the intraocular pressure of the right eye was 27 mmHg. The ACL was repositioned because of low cell density (1222 cells/mm2). After 6 months, the visual acuity of the right eye was 0.3, best corrected visual acuity was 0.8, intraocular pressure was 12 mmHg and cell density was 838 cells/mm2. There were no inflammation signs or complications.
CONCLUSIONS
Reinserting ACL when the haptic is protruding into the subconjunctiva could be a simple and safe method when a decrease in corneal endothelial cell density is present.

Keyword

Anterior chamber intraocular lens; Cell density; Haptic protrusion; Reinsertion

MeSH Terms

Anterior Chamber
Cataract
Cell Count
Endothelial Cells
Eye
Humans
Inflammation
Intraocular Pressure
Lenses, Intraocular
Visual Acuity

Figure

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  Figure 1. Haptic of anterior chamber intraocular lens pro-trudes into subconjunctival space at 11-1 o’clock perilimbal area, and two endings of haptic expose (arrows).

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  Figure 2. Preoperative cell density is 1222 cells/mm2.

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  Figure 3. Anterior chamber intraocular lens is repositioned at 2-8 o’clock. Corneo-scleral hole is shown at the site where haptic was incarcerated previously (arrow).

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  Figure 4. Scleral free flap (1/3 thickness of sclera, 3 mm × 3 mm) covers corneo-scleral hole.

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  Figure 5. Postoperative (6 months later) cell density is 838 cells/mm2.

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  Figure 6. After 6 months later from operation day, reinserted anterior chamber intraocular lens (ACL) in situ at 2-8 o’clock axis. The area covered with scleral free flap well resolved (arrow).

Reference

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