This patient was referred to you for a “slightly dislocated IOL” and this is what you see. There is a single piece acrylic IOL that is severely decentered and there appears to be some sort of capsule remnant tangled with the optic. What are your options for rescuing this case? Do you attempt to suture fixate this IOL? Or do you perform an IOL exchange?
Would remove the present IOL, perform a thorough vitrectomy and implant a secondary IOL – choices can be AC IOL, IRIS fixated one or a scleral fixated one
I was wondering if this patient had an optic capsure procedure as I had performed in my left eye when I had cataract surgery a few years ago at the University of Iowa. It did not work well for me as I have an IOL now loose behind my pupil rubbing cells off the back side of my pupil. This is allowing too much light in my eye now and causing bad floaters. My right eye did not have optic capsure and the lens stayed in the capsule bag. I have three options that are none of them without consequences. 1 Do nothing. 2 Have the lens sutured to my iris.( this is what has been recommended to me by the U of a iowa staff ) or 3 have a Yamane done possibly with a new lens. I am prone to macula edema after the surgery as I have Marfans. I hope things work out well for this patient as this was a major surgery with a lot of possible complications .