Management of dislocated posterior chamber intraocular lenses

Management options for posteriorly dislocated posterior chamber intraocular lenses include observation, removal, exchange, and repositioning. Many microsurgical techniques have been developed for repositioning posterior chamber implants. These include repositioning into the ciliary sulcus without suturing if adequate posterior capsule support remains, iris fixation suturing techniques, and scleral fixation suturing techniques. The indications, timing, and techniques for intervention are reviewed in a series of 32 cases with posteriorly dislocated posterior chamber implants. A final visual acuity of 20/40 or better was achieved in 15 (79%) of 19 IOL repositioned cases, in 6 (75%) of 8 IOL exchanged cases, and in 1 (33%) of 3 IOL removed cases. In two patients observed without surgery, final visual acuity was 20/25 and 20/300, respectively.