[Vitrectomy and perfluorocarbons in the management of luxated lenses]

To evaluate the use of vitrectomy with perfluorocarbon liquids (Perfluoro-DK-line) (PFCL) to refloat the luxated lenses of surgical etiology. Follow-up complications are considered.

The cases with vitreous posteriorly luxated lenses were reviewed between 1989 and 1999. 8 cases were found, all had similar surgery with vitrectomy and PFCL performed by the same surgeon. In two cases an anterior chamber IOL and in 6 cases a posterior chamber IOL sulcus fixated were used.

The average age of the 8 cases with unilateral vitreous luxated lenses of no surgical etiology was 64.5 years. 3 of them were myopic with a history of spontaneous luxation with a duration of 5.9 and 10 years respectively. The other 5 cases reported a history of ocular trauma with a shorter time of luxation (between 1 week and 3 years). 7 cases (87.5%) had ocular hypertension, 6 cases (75%) showed epithelial corneal edema and one case retinal detachment preoperatively. Vitrectomy with PFCL normalized IOP and corneal edema. The complications related with decreased final VA were cystoid macular edema (1 case), macular atrophy (1 case) and retinal detachment (1 case). Only in one case a postsurgical retinal detachment was found likely to be iatrogenic.

As vitrectomy with PFCL simplifies surgical technique with good results and modern sulcus fixated IOL may be used during the same surgery offering visual restoration, we believe this combined technique must be recommended always after posterior lens dislocation, to prevent complications and to preserve visual acuity.