Efficacy of Removing Dislocated Lens using Intravitreal Phacoemulsification

Purpose:To evaluate the efficacy of intravitreal phacoemulsification in the removal of dislocated crystalline lenses.Methods:Twenty-two cases (22 eyes) with posterior dislocated lens induced by ocular trauma or capsule rupture during phacoemulsification between January 2008 and December 2010 were retrospectively analyzed in this study.Total vitrectomy was first performed through standard closed three-port incisions at the pars plana,and dislocated lenses were removed using the phacoemulsification tip without the silicone sleeve.Extraction of intraocular foreign body,endolaser retinal photocoagulation and intraocular lens implantation were performed simultaneously.Visual acuity,intraocular pressure (IOP) and postoperative complications were assessed over 1 to 3 months of follow up.Results:All dislocated lenses were extracted without severe complication.The final corrected visual acuity was ≥ 6 /15 in 7 cases,6 /100-6 /18 in 5 cases and ≤ 6 /120 in 10 cases,a significant improvement over preoperative values (P <0.05).The IOP in 10 cases (10 eyes) with secondary glaucoma was < 21 mmHg post-operatively.Intraocular foreign bodies in 3 eyes were removed.Nine patients (9 eyes) underwent intraocular lens implantation.No instances of retinal detachment,retinal hemorrhage or scleral wound burn were observed after surgery.Conclusion:Intravitreal phacoemulsification combined with vitrectomy yielded good efficacy and safety in the treatment of posteriorly dislocated lens.It may be an alternative to phacofragmentation in the treatment of posteriorly dislocated lenses.