Inferior Removal of Dislocated Polymethyl Methacrylate Intraocular Lens and Scleral Refixation in Glaucomatous Eyes

Akihiko Shiraki; Susumu Sakimoto; Yoshinori Oie; Takeshi Soma; Atsuya Miki; Shinichi Usui; Shigeru Sato; Kenji Matsushita; Hirokazu Sakaguchi; Kohji Nishida

doi:10.1007/s40123-022-00477-z

Inferior Removal of Dislocated Polymethyl Methacrylate Intraocular Lens and Scleral Refixation in Glaucomatous Eyes

Ophthalmol Ther. 2022 Apr;11(2):881-886. doi: 10.1007/s40123-022-00477-z. Epub 2022 Feb 21.

Authors

Akihiko Shiraki¹, Susumu Sakimoto^{2

3}, Yoshinori Oie¹, Takeshi Soma¹, Atsuya Miki^{1

4}, Shinichi Usui¹, Shigeru Sato¹, Kenji Matsushita¹, Hirokazu Sakaguchi⁵, Kohji Nishida^{1

6}

Affiliations

¹ Department of Ophthalmology, Osaka University Graduate School of Medicine, 2-2 E7 Yamadaoka, Suita, Japan.
² Department of Ophthalmology, Osaka University Graduate School of Medicine, 2-2 E7 Yamadaoka, Suita, Japan. susumu.sakimoto@ophthal.med.osaka-u.ac.jp.
³ Integrated Frontier Research for Medical Science Division, Institute for Open and Transdisciplinary Research Initiatives (OTRI), Osaka University, Suita, Japan. susumu.sakimoto@ophthal.med.osaka-u.ac.jp.
⁴ Department of Innovative Visual Science, Osaka University Graduate School of Medicine, Yamadaoka, Suita, Japan.
⁵ Department of Ophthalmology, Gifu University Graduate School of Medicine, Gifu, Japan.
⁶ Integrated Frontier Research for Medical Science Division, Institute for Open and Transdisciplinary Research Initiatives (OTRI), Osaka University, Suita, Japan.

Abstract

Introduction: The aim of this study was to report a technique for the removal of dislocated polymethyl methacrylate (PMMA) intraocular lenses (IOLs) in glaucomatous eyes.

Methods: Dislocated PMMA IOLs were removed from the inferior sclerocorneal incision, and sutureless intrascleral fixation of each IOL was performed to preserve the intact superior conjunctiva and sclera for future trabeculectomy or to maintain a functional filtering bleb of trabeculectomy.

Results: In two cases, the condition of the bleb did not change, while the intraocular pressure improved or did not change after the procedures. IOL fixation was stable with no complications, such as tilt, decentration, or extrication of the IOL haptics.

Conclusion: This procedure of preserving the superior conjunctiva and sclera can maintain the function of the bleb, superior cornea and sclera and may contribute to the success of future trabeculectomy.

Keywords: Dislocated intraocular lens; Filtering bleb; Glaucoma; Polymethyl methacrylate; Sutureless intrascleral fixation.