First Author: S.O.Yong SINGAPORE
Co Author(s): 0 0 0 0 0 0 0 0 0
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Case report describing the management of a patient with posterior dislocation of a 3-piece multifocal IOL
Tertiary Ophthalmology referral centre
An 80 y.o. Chinese male presented with sudden onset monocular diplopia, and a visual acuity of 6/24. Ocular examination showed an inferiorly subluxed multi-focal IOL. Over the course of the next 5 days, the IOL dislocated completely through a large posterior capsulotomy defect, with a corresponding drop in VA to CF@ 1m. The patient’s unaided VA prior to dislocation of the lens had been 6/18, with a BCVA of 6/7.5. 23G 3-port trans-pars plana vitrectomy and IOL rescue was performed, and the rescued IOL was scleral-fixated using the Schiaroth technique. Sclerotomy placement was selected to correct for existing corneal cylinder of -2.00D.
Post-operative recovery was uneventful and the patient achieved an uncorrected visual acuity of 6/7.5, with near acuity of N5 at 35cm. This was, subjectively and objectively, an improvement over his unaided visual acuity prior to dislocation of the IOL. Addition of refractive correction (PL/-0.75x60) did not improve his vision any further.
The Schiaroth technique may be used to fixate multi-focal IOLs with good visual and refractive outcomes in the absence of adequate capsular support.