Additionally, there is no reference on pupil and visual axis. They also have the advantage of visualization of IOL tilt, but it is difficult to achieve same cross-sectional images for follow up of stability. 8 Both are useful in studying the anatomical relationship of the subluxated IOL with the ocular structures. Other techniques that have been proposed for evaluation of IOL subluxation are ultrasound biomicroscopy 7 and anterior segment optical coherence tomography (AS-OCT). More significantly, in slit lamp photo there is no reference to pupil center and visual axis of the patient, which are optically significant reference points with regard to the IOL position. In addition, evaluation of the IOL position with respect to the pupil is difficult, as the pupil usually does not have the same diameter in each depiction. A limitation of slit lamp photography is the difficulty to repeat depiction with the patient fixating at the same reference point each time. This technique, albeit very useful, has a few limitations. 2,4 In our patient we decided to operate only on the right eye and to follow up the left eye in order to evaluate stability.įollow up on such eyes is usually done by evaluation with slit lamp photography. 1–6 In cases where no treatment is undertaken, close follow up with observation is required in order to confirm the stability of the IOL position. Treatment consists of IOL reposition or replacement, with additional measures such as scleral suturing, whenever needed in order to avoid recurrence. When visual disturbance is significant, surgical management is required. This postoperative complication can lead to significant deterioration of the patient's visual acuity, and symptoms such as monocular diplopia, glare and haloes. Intraocular lens subluxation/dislocation is a potentially progressive condition that can occur even in the late postoperative period after cataract surgery and IOL implantation. As a result, no intervention was planned. IOL position was stable in the left eye, as evaluated with respect to the pupil center and the corneal vertex in the eye images of the iTrace. Image center coincides with pupil center when measurement of aberrations is centered in the pupil. Evaluation of the IOL position was assisted by the instrument software, which shows the distance in mm and the angle distance of the pointer position on the image from the image center. Assessment of the IOL position was repeated with the iTrace 4 and 7 months after first visit ( Fig. Six months postoperatively CDVA in right eye was 20/20 with manifest refraction of +1.50–3.00 × 90° and CDVA in left eye was 20/25 with manifest refraction of −3.25–2.50 × 125°. IOL position is stable when compared to the reference points.Īn IOL exchange was planned and performed after 1 month for the right eye, while for the left eye it was proposed to repeat examination in order to evaluate if IOL subluxation was progressive. All rights reserved.Images captured with the iTrace showing the IOL position with respect to the pupil center (green cross) and the corneal vertex (red cross) of the left eye: (a) first visit, (b) 4-month follow up, (c) 7-month follow up. Privacy | Terms & Conditions Ⓒ 2022 Beye, LLC. Inclusion of advertising materials on the website thereof, does not constitute and representation or guarantee by Beye LLC of the quality of such products, or of the claims made. References made in article may indicate usage of medical equipment or drugs at dosages, for periods of time, and in combination not included in the current prescribing information. Although great care is taken to ensure that all information is accurate, it is recommended that readers seek independent verification of advice on drugs and other product usage, surgical techniques and clinical processes prior to their use. Beye LLC, via its Editors and Publisher, accepts no responsibility for any injury or damage to persons or property occasioned through the implementation of any ideas or use of any product described herein. The information contained on, including text, graphics, images, and interactive activities, is for informational purposes only, and is not intended to be a substitute for professional medical advice. This content is intended for health care professionals and providers only.
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