Management of posteriorly dislocated intraocular lenses

Posterior dislocation of an intraocular lens (IOL) into the vitreous cavity can be a serious problem, and probably will become more frequent because of increasing popularity of posterior-chamber lenses. We describe techniques for managing a posteriorly dislocated lens that cannot be repositioned in its proper location by medical means. Vitrectomy instrumentation and techniques through a pars plana approach provide optimal visualization during manipulation of the intraocular lens, minimize vitreoretinal traction and permit one to reposition the IOL in its proper location relative to the iris or to position it in the anterior chamber in preparation for removal. A modification of the McCannel iris-fixation suture technique is also presented.