Retained Lens Fragments, Dislocated Intraocular Lenses, and Sutured Intraocular Lenses

What are Retained Lens Fragments?

After complex cataract surgery or trauma affecting the eye lens it can be difficult to retrieve all lens material without compromising the safety of the eye. In this case, the cataract surgeon removes as much lens material as safely possible and plans for removal of the remaining lens material by a Retinal surgeon via Vitrectomy surgery. In some circumstances, a lens implant cannot be placed at the same time of cataract surgery, and an anterior chamber or a scleral fixated intraocular (IOL) lens can be placed at a later date.

Fundus photo of the left eye with a dislocated intraocular lens and bag complex. Patient had a prior scleral buckle and vitrectomy for retinal detachment.

What is a Dislocated Intraocular Lens?

A dislocated IOL is a rare condition that affects patient who have undergone cataract surgery and consists of displacement of the implant lens towards the front or back part of the eye. Most of the time is displaces posteriorly into the vitreous cavity.

How do I know if my IOL dislocated?

Patients can notice sudden decrease in vision and occasionally they can experience blurring of vision with position changes. Other signs and symptoms include glare, double vision and increased astigmatism. Occasionally, the IOL can dislocate anteriorly and cause eye inflammation and increased eye pressure which can result in eye pain, light sensitivity and blurred vision.

If you are experiencing any of these symptoms you should seek care from your Ophthalmologist and/or Retina specialist.

How are these conditions diagnosed?

A trained Ophthalmologist performs a dilated eye exam by administering eye drops to dilate (open up) the pupil allowing the eye doctor to see the intraocular lens or the retained lens fragments in the vitreous cavity (back part of the inside of the eye).

How is it treated?

The natural lens in the eye sits in a bag that is suspended by strings called zonules, when the lens becomes a cataract it blurs vision and can be removed by cataract surgery. If either the zonules or the bag are compromised, a standard lens implant cannot be placed. In this scenario, a lens has to be sutured to the eye wall as it cannot be placed inside the bag the native lens was in.

A total or partial vitrectomy is required to remove the vitreous gel followed by fixating of the IOL to the eye wall. There are a number of techniques to fixate an IOL to the eye wall including glued IOLs, sutured IOLs, and Yamane style intrascleral haptic fixation, among others. Additionally, an IOL can be placed in the anterior chamber (in front of the iris, the colored part of the eye).