2998: sulcus IOL damages ciliary processes
This compelling case highlights a major hidden risk of secondary lens placement: a malpositioned sulcus IOL damaging the ciliary processes. When a patient presents with chronic inflammation, recurrent hyphema, or UGH syndrome, direct visualization is key. In this video, our guest surgeon confirms the diagnosis via intraocular endoscopy, clearly catching the offending haptic eroding into the ciliary processes. To resolve the ongoing trauma, the unstable lens is explanted and successfully replaced with a secure Yamane scleral-fixated IOL (SFIOL). Watch the video to see how endoscopy provides undeniable proof of the issue and how a sutureless transscleral approach offers an elegant long-term solution.Have you ever used endoscopy to diagnose a mysterious case of chronic postoperative inflammation? Comment your thoughts below.
It should be noted that there will be a significant hyperopic shift moving the IOL from the sulcus to Yamane ISHF so if the patient has a desired refractive outcome in the sulcus the shift will make them about +1.0 hyperopic. In this situation I usually exchange for a proper power IOL to compensate for that. In my hands it’s just as easy to exchange as to reuse the offending IOL and in this case it appears to be an Acrysof which will develop SSNG and glistenings if it hasn’t already so another reason to exchange.