Management of subluxed and dislocated intraocular lenses in patients with uveitis: a practical approach.

ABSTRACT

Purpose: To describe practical approaches to the management of subluxed or dislocated intraocular lenses (IOL) in patients with uveitis.Patients and methods: Retrospective case series from a specialist uveitis clinicResults: Fifteen IOLs in 13 patients were subluxed inferiorly (12) or dislocated into anterior chamber (2) or vitreous (1) at a mean delay of 12 years after cataract surgery. Six eyes required vitrectomy and seven IOL explantation. A dislocated IOL was repositioned by scleral fixation in one, and a new IOL was implanted in three (two scleral-sutured, one iris-claw). Eight were observed without surgery and 7 were left functionally aphakic (4 corrected with contact lens). The mean final best-corrected visual acuity was 0.6 LogMAR.Conclusions: There are several management choices for IOL dislocation which should take into account the degree of uveitis, patient age and expectations. We present a pragmatic approach: surgery can often be avoided in this high-risk group.