Resuturing a Dislocated Scleral-Fixated Intraocular Lens in Brown-McLean Syndrome.

Area of Science:

• Ophthalmology
• Corneal Diseases
• Intraocular Lens Technology

Background:

• Brown-McLean syndrome (BMS) is a rare peripheral corneal edema.
• It can occur years after cataract surgery or intraocular lens (IOL) implantation.
• This study reviews BMS clinical features, etiologies, and surgical outcomes.

Observation:

• A case of IOL dislocation in a patient with BMS after scleral fixation is presented.
• The patient experienced reduced vision due to BMS-related corneal edema and partial IOL dislocation.
• A literature search identified 169 patients with BMS, with only four undergoing intraocular surgery post-onset.

Findings:

• Scleral fixation of a dislocated IOL was successfully managed by resuturing the haptic using an ab externo approach.
• Postoperative visual acuity improved from 0.6 to 0.9.
• The IOL remained stable one year post-surgery, with persistent peripheral edema and a slight decrease in endothelial cell density.

Implications:

• Partial resuturing of scleral-fixated IOLs is an effective strategy for managing IOL dislocation in BMS.
• This technique reduces surgical invasiveness and endothelial trauma compared to explantation.
• Long-term endothelial cell monitoring is recommended due to the chronic nature of BMS.