Retinal detachment complicating scleral-sutured posterior chamber intraocular lens surgery

Although retinal detachment has been reported in association with sutured posterior chamber intraocular lenses (PCIOL), detailed analysis of the pathogenesis, clinical features and risk factors is lacking. Thirty-nine patients who had undergone surgery for scleral-sutured PCIOL were therefore reviewed, revealing 8 patients with associated retinal tears or detachments. Retinal breaks resulted from vitreous incarceration by the intraocular suture (6), post-operative vitreous detachment (1), preretinal manipulation of the dislocated PCIOL (1), surgical entry-sites (1) and surgical induction of posterior vitreous detachment (1). An axial length > 25 mm was associated with the development of retinal tears (p < 0.05, Fisher's exact test). All patients had attached retina with median visual acuity of 6/12 (range 6/6 to CF) at last follow-up (median 15 months, range 1-41 months). In patients requiring a pars plana approach, careful attention to the posterior hyaloid face, basal gel, surgical entry-sites and suture tract is recommended to reduce the risk of retinal detachment associated with scleral-sutured PCIOL procedures.