Sleeveless-extrusion cannula for levitation of dislocated intraocular lens

To characterise a sleeveless-extrusion cannula-based suction technique to levitate dislocated intraocular lens (IOLs) and review the surgical outcome.

This retrospective, non-comparative, single surgeon, interventional, consecutive case series examined 10 patients (10 eyes) who underwent the surgical procedure from October 2011 to December 2012. Reliability, reproducibility, and intraoperative and postoperative complications of the technique were analysed.

The technique involved suction levitation of a 3-piece acrylic foldable IOL in six cases, 1-piece acrylic foldable IOL in three cases and a plate haptic IOL in one case. The IOL was exchanged in four eyes whereas the same IOL was repositioned in six eyes with sulcus repositioning in two eyes and glued intrascleral fixation in four eyes. Intraoperative suction loss and a subsequent IOL dislocation were reported in 1 (10%) eye. Early preoperative complications included pigment dispersion in 1 (10%) eye, grade 2 anterior chamber cellular reaction in 2 (20%) eyes and intraoperative corneal oedema in 1 (10%) eye which resolved with medical line of management. Intermediate and late complications included macular oedema in one patient (10%) which resolved considerably with medical line of management. No incidence of postoperative vitreous or retinal haemorrhage, retinal break or retinal detachment was reported.

The early results demonstrate this surgical intervention as a reliable, reproducible and an effective alternative treatment option for levitation of dislocated IOLs with a low complication rate.