[Indications and techniques for removal of subluxated lenses (author's transl)]

Extraction only appears indicated in cases of anteriour luxation and phakolytic glaucoma. Visual disturbances due to a dislocated lens should be considered relative indications for removal, since functional improvement cannot be expected as a rule. Expression of the lens through a corneoscleral incision is the method of choice in cases of anterior luxation (Fig. 1) as well as in subluxations without vitreous prolapse (Fig. 2) Open-sky vitrectomy allows for clearing of the route of extraction in cases of subluxation with vitreous in the anterior chamber (Fig. 3). A pars plana approach may be chosen in cases with a soft nucleus (Fig. 4) whereas luxated lenses with a hard nucleus are first aspirated (soft capsule and cortex), then the hard nucleus is luxated into the anterior chamber and finally extracted through a small corneoscleral incision, thus avoiding prolonged perfusion of the anterior chamber necessary for stripper techniques.