Objective of surgery: The aim is the explantation of an intraocular lens (IOL) due to dislocation into the vitreous cavity with subsequent secondary implantation of a retropupillary iris claw IOL via the pars plana without creating a large corneal incision. The aim of the operative technique is to avoid corneal astigmatism after secondary IOL implantation, faster recovery of visual acuity and reduction of invasive maneuvers in the anterior chamber.
Indications: The surgery is indicated by an in-the-bag dislocation of a posterior chamber lens into the vitreous cavity without the possibility of refixation due to zonulopathy.
Contraindications: Contraindications are extensive iris stromal defects, iritis, scleromalacia, ischemic retinopathies.
Surgical technique: The technique consists of explantation of the IOL during a standard pars plana vitrectomy (20 gauge) with an extended sclerotomy and subsequent secondary implantation of a retropupillary iris claw IOL using the same sclerotomy. The operation video is available online.
Follow-up: Treatment is carried out with local steroids and antibiotic eyedrops for 3 weeks. In the case of a corneal suture, removal is recommended after 14 days.
Evidence: The implantation of a retroiridal iris claw lens is an established procedure. The introduction via the pars plana in the presented form is a first description.
Keywords: Intraocular lens dislocation; Iris fixation; Scleral fixation; Secondary intraocular lens implantation; Surgical technique.