[Surgical solutions to luxation of the IOL--capsular bag--capsular tension ring complex].

J Fr Ophtalmol

Département d'Ophtalmologie, Clinique Ophtalmologique Saint-Victor, CHU d'Amiens, 354, boulevard Beauvillé, 80000 Amiens.

Published: February 2007

Introduction: The spontaneous luxation of the intraocular lens-capsular bag-capsular tension ring complex is a serious but fortunately rare complication. The authors report a combined surgical procedure to reposition the complex in a patient who was operated on for bilateral lens subluxation 4 years before and whose enophthalmia made surgery difficult.

Case Report: Two surgical techniques can be considered to reposition the complex and avoid explantation. The McCannel modified stitch can capture the complex with the help of a transcorneal point and then a transscleral suture on the 12 o'clock meridian, despite the enophthalmia of the patient; the Moreno transscleral stitch. Both techniques suture the complex to the ciliary sulcus.

Conclusion: Moreno's technique is easy and safe for the endothelium and must therefore be attempted first. In case of failure, the McCannel modified stitch remains a useful and satisfying procedure allowing transscleral fixation of the complex to the sulcus at the cost of a minimal corneal trauma.

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http://dx.doi.org/10.1016/s0181-5512(07)89563-5DOI Listing

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