Broken semiflexible intraocular lens implant

Area of Science:

• Ophthalmology
• Biomedical Engineering

Background:

• Intraocular lenses (IOLs) are commonly implanted during cataract surgery.
• Semiflexible anterior chamber IOLs, such as the Kelman Quadraflex, have been used in specific clinical situations.

Observation:

• A 70-year-old male patient experienced spontaneous haptic fracture of an implanted Kelman Quadraflex IOL within the anterior chamber.
• Clinical signs included progressive inferior corneal edema and a significant, rapid decline in corneal endothelial cell density.
• The fractured haptic segment was observed to be free-floating within the anterior chamber.

Findings:

• Haptic fracture of the Kelman Quadraflex IOL occurred without apparent history of trauma.
• The free-floating haptic segment induced significant corneal edema and endothelial cell loss.
• Surgical management involved haptic and IOL removal, penetrating keratoplasty, and vitrectomy.

Implications:

• This case highlights a rare complication of IOL material failure, specifically haptic fracture.
• Corneal edema and endothelial decompensation are potential consequences of free-floating intraocular fragments.
• Complex surgical management may be required to address such complications and preserve visual function.