Severe intraocular lens tilt after the Yamane technique
Neil Kelkar1, Kevin Eid, Austin S Nakatsuka
1From the Intermountain Ocular Research Center, Department of Ophthalmology and Visual Sciences, John A. Moran Eye Center, University of Utah, Salt Lake City, Utah (Kelkar, Eid, Mamalis, Werner); Alan S. Crandall Center for Glaucoma Innovation, Department of Ophthalmology and Visual Sciences, John A. Moran Eye Center, University of Utah, Salt Lake City, Utah (Nakatsuka, Johnson).
Purpose:
To evaluate CT Lucia 602 intraocular lenses implanted in cases lacking capsular support and explanted because of decentration/dislocation with subsequent pathological analysis. The main objectives were to (1) document the status of haptics and (2) verify the presence of the rotisserie effect.
Setting:
John A. Moran Eye Center, University of Utah, Salt Lake City, Utah.
Design:
Case series with clinicopathological correlation.
Methods:
13 explanted CT Lucia 602 lenses were included: 12 implanted by the Yamane technique and 1 that was iris-fixated. 4 lenses were explanted between October 2020 and February 2022. 9 lenses, explanted between November 2022 and February 2024, also exhibited severe optic tilt, leading to explantation. A chart review was performed to obtain clinical information from each case. Explanted lenses underwent gross and microscopic examination for haptic status and rotation, in the dry state (room temperature) and after hydration (body temperature).
Results:
Time between implantation and explantation was longer for lenses explanted before November 2022 (without severe tilt). Among the 26 haptics evaluated, 15 were deformed, 6 were broken, 2 were detached, and 3 were unremarkable. 4 haptics of Yamane lenses explanted between November 2022 and February 2024 showed free rotation within the optic insertion, after hydration at body temperature.
Conclusions:
Anecdotal reports of the rotisserie effect of CT Lucia 602 lenses implanted by the Yamane technique appeared mostly during the second half of 2022 and suggested that affected lenses were from specific batches, which seems to be consistent with the findings of this study.
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