Reinsertion of the Anterior Chamber Intraocular Lens with Long-Term Protruded Haptic

Moses Kim; Sungmin Hyung

doi:10.3341/jkos.2013.54.6.966

Journal List > J Korean Ophthalmol Soc > v.54(6) > 1009713

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Kim and Hyung: Reinsertion of the Anterior Chamber Intraocular Lens with Long-Term Protruded Haptic

Original Article

J Korean Ophthalmol Soc 2013;54(6):966-970.

Published online: 7 September 2013

DOI: https://doi.org/10.3341/jkos.2013.54.6.966

Reinsertion of the Anterior Chamber Intraocular Lens with Long-Term Protruded Haptic

Moses Kim, MD, Sungmin Hyung, MD, PhD

Department of Ophthalmology, Chungbuk National University College of Medicine, Cheongju, Korea

Address reprint requests to Sungmin Hyung, MD, PhD Department of Ophthalmology, Chungbuk National University Hospital #776 1st Sunhwan-ro, Heungdeok-gu, Cheongju 361-711, Korea Tel: 82-43-269-6368, Fax: 82-43-269-5263, E-mail: smh@chungbuk.ac.kr

Received 26 October 20124 December 2012 Accepted 22 March 2013

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

To report a case of anterior chamber intraocular lens (ACL) reposition with the haptic protruded into the subcon-junctiva in a patient with a previous ACL implantation.

Case summary

A 64-year-old man visited our clinic because of visual disturbance and discomfort in his right eye. Approximately 8 years earlier, he had cataract surgery and there was no visual improvement but eye discomfort. The hap-tic of the ACL protruded into the subconjunctiva at 11-1 o’clock. The visual acuity of the right eye was 0.2 and the intra-ocular pressure of the right eye was 27 mmHg. The ACL was repositioned because of low cell density (1222 cells/mm²). After 6 months, the visual acuity of the right eye was 0.3, best corrected visual acuity was 0.8, intraocular pressure was 12 mmHg and cell density was 838 cells/mm². There were no inflammation signs or complications.

Conclusions

Reinserting ACL when the haptic is protruding into the subconjunctiva could be a simple and safe method when a decrease in corneal endothelial cell density is present.

Keywords: Anterior chamber intraocular lens, Cell density, Haptic protrusion, Reinsertion

References

1. Kim SH, Kim IC, Chung YT. Results of Nuvita phakic anterior chamber intraocular lens for high myopia. J Korean Ophthalmol Soc. 2001; 42:1721–8.

2. Yi TK, Kwon JS, Shin DE. Visual outcome and complications of Modern Kelman style anterior chamber intraocular lens implantation. J Korean Ophthalmol Soc. 1999; 40:2773–84.

3. Moses L. Complications of rigid anterior chamber implants. Op- hthalmology. 1984; 91:819–25.

4. Yeom IY, Chang JH, Jung YC. A clinical study on implantation of anterior chamber intraocular lens and posterior chamber intra-ocular lens by scleral fixation in eyes without capsular or zonular support. J Korean Ophthalmol Soc. 1993; 34:950–5.

5. Jang BH, Lee DW, Cho NC, Ahn M. Clinical results of anterior chamber phakic intraocular lens. J Korean Ophthalmol Soc. 2006; 47:31–6.

6. Drews RC. The Barraquer experience with intraocular lenses. 20 years later. Ophthalmology. 1982; 89:386–93.

7. Wolter JR. Foreign body giant cells selectively covering haptics of intraocular lens implants. indicators of poor toleration? Ophthalmic Surg. 1983; 14:839–44.

8. Yeo JH, Jakobiec FA, Pokorny K. . The ultrastructure of an IOL “cocoon membrane”. Ophthalmology. 1983; 90:410–9.

9. Lee E, Park SJ, Kwon JD. A case of Ahmed glaucoma valve im-plantation without removal of the anterior chamber lens. J Korean Ophthalmol Soc. 2011; 52:746–52.

10. Kim SI, Na KS, Kwon HG. . Effect of anterior chamber depth on corneal endothelial change after phacoemulsification. J Korean Ophthalmol Soc. 2010; 51:1568–72.

11. Choi DW, Kim EJ, Chung IY. . Clinical study on anterior chamber intraocular lens implantation in completely vitrectom-ized eyes. J Korean Ophthalmol Soc. 2005; 46:45–50.

12. Oh SY, Lee JH. The effect of the posterior chamber IOL im-plantation by suture fixation of the number of central corneal endo-thelial cells. J Korean Ophthalmol Soc. 1994; 35:58–62.

Figure 1.

Haptic of anterior chamber intraocular lens pro-trudes into subconjunctival space at 11-1 o’clock perilimbal area, and two endings of haptic expose (arrows).

Figure 2.

Preoperative cell density is 1222 cells/mm².

Figure 3.

Anterior chamber intraocular lens is repositioned at 2-8 o’clock. Corneo-scleral hole is shown at the site where haptic was incarcerated previously (arrow).

Figure 4.

Scleral free flap (1/3 thickness of sclera, 3 mm × 3 mm) covers corneo-scleral hole.

Figure 5.

Postoperative (6 months later) cell density is 838 cells/mm².

Figure 6.

After 6 months later from operation day, reinserted anterior chamber intraocular lens (ACL) in situ at 2-8 o’clock axis. The area covered with scleral free flap well resolved (arrow).

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