Program list

SYMPOSIUM: STRATEGIES
SECTION: When anterior segment comes and complicates everything
Moderators: Anne-Catherine Gribomont, Jean-Pierre Hubschman
Tuesday, September 16th, 2003 ;12:00 - 13:00

RETINAL DETACHMENT WITH PVR IN MYOPIC EYES AFTER PHAKIC
INTRAOCULAR LENS IMPLANTATION
Murat Oncel
Turkey

Purpose: To report a case series of rhegmatogenous retinal detachment(RRD) after phakic intraocular lens(IOL) implantation and its incidence.
Methods: Retrospective interventional case series. Seven eyes that developed RRD after phakic IOL implantation were described. Surgery was performed in all of the seven eyes to repair the RRD. The mean follow-up time was 10 months after vitreoretinal surgery.
Results: 7 eyes (6 patients) developed RRD after phakic IOL surgery. RRD occured between 45 days and 36 months after phakic IOL surgery. Eyes that developed RRD had from -8.00 to -19 D of myopia(mean:-13.5 D) before phakic IOL implantation. 2 eyes had RRD within 2 months after phakic IOL surgery. RRD were managed with vitrectomy, pars plana lensectomy, carefull vitreous base dissection, air-fluid exchange, argon laser photocoagulation and 14-16% C3F8 gas tamponade. Two eyes developed retinal dethachment with macular hole after surgery. These were treated with trypan blue-assisted peeling of the ILM and silicone oil tamponade. 4 eyes had some form of cataract before vitrectomy was performed. The incidence of RRD after phakic IOL surgery in our study is 0.57%(7/1210).
Conclusion: Rhegmatogenous retinal dethacment after phakic IOL surgery is a serious complication. The true prevalence and causes of retinal pathology after phakic IOL implantation can only be determined through a large prospective study. Careful retinal examination with scleral depression for detection of breaks and lattice degeneration followed by possible prophylactic treatment prior to phakic IOL surgery is recommended.
Take home message: Retinal detachment after phakic IOL surgery is a serious complication, prophylactic treatment prior to phakic IOL surgery is recommended.