3/13/2017 IntraocularLensDislocationWorkup:ImagingStudies,HistologicFindings

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IntraocularLensDislocationWorkup
Updated:Sep29,2015
Author:LihtehWu,MDChiefEditor:HamptonRoy,Sr,MDmore...

WORKUP

ImagingStudies
Ifavitreoushemorrhageorseverecornealedemaispresent,Bscanultrasonicimagingshouldbe
usedtodeterminethepositionoftheIOLandthepresenceorabsenceofretinaldetachment.

HistologicFindings
Studiesincadavereyesindicatethattransscleralsuturesmustexitthesclera0.8mmposteriorto
thelimbusintheverticalmeridianand0.46mmposteriortothelimbusinthehorizontalmeridianto
bewithinthetrueciliarysulcus.

PostmortemstudiesdisclosedthatscarringdoesnotoccurinthevicinityofthesuturedIOL.The
hapticsaresurroundedbyathinfibrouscapsuleattheirattachmentsite.Thetransscleralportionof
thesutureischaracterizedbythelackofinflammation.Inaddition,thesuturetipusuallyisexposed
externally.Ifthefixationsutureswerecut,theIOLwoulddislocatebackintothevitreouscavity.It
wasconcludedthatthestabilityoftheIOLwasprimarilyaresultofintacttransscleralsuturesand
notfibrousencapsulationorciliarysulcusplacementofthehaptics.

Treatment&Management

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ContributorInformationandDisclosures

Author

LihtehWu,MDOphthalmologist,CostaRicaVitreoandRetinaMacularAssociates

LihtehWu,MDisamemberofthefollowingmedicalsocieties:AmericanAcademyof
Ophthalmology,AmericanSocietyofRetinaSpecialists,AssociationforResearchinVisionand
Ophthalmology,ClubJulesGonin,MaculaSociety,PanAmericanAssociationofOphthalmology,
RetinaSociety

Disclosure:Receivedincomeinanamountequaltoorgreaterthan$250from:BayerHealth
QuantelMedicalHeidelbergEngineeringNovartis.

Coauthor(s)

RafaelAlbertoGarca,MD

Disclosure:Nothingtodisclose.

RobertHGraham,MDConsultant,DepartmentofOphthalmology,MayoClinic,Scottsdale,
Arizona

RobertHGraham,MDisamemberofthefollowingmedicalsocieties:AmericanAcademyof
Ophthalmology,ArizonaOphthalmologicalSociety,AmericanMedicalAssociation

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3/13/2017 IntraocularLensDislocationWorkup:ImagingStudies,HistologicFindings

Disclosure:PartnerreceivedsalaryfromMedscape/WebMDforemployment.

SpecialtyEditorBoard

SimonKLaw,MD,PharmDClinicalProfessorofHealthSciences,DepartmentofOphthalmology,
JulesSteinEyeInstitute,UniversityofCalifornia,LosAngeles,DavidGeffenSchoolofMedicine

SimonKLaw,MD,PharmDisamemberofthefollowingmedicalsocieties:AmericanAcademyof
Ophthalmology,AssociationforResearchinVisionandOphthalmology,AmericanGlaucoma
Society

Disclosure:Nothingtodisclose.

SteveCharles,MDDirectorofCharlesRetinaInstituteClinicalProfessor,Departmentof
Ophthalmology,UniversityofTennesseeCollegeofMedicine

SteveCharles,MDisamemberofthefollowingmedicalsocieties:AmericanAcademyof
Ophthalmology,AmericanSocietyofRetinaSpecialists,MaculaSociety,RetinaSociety,Club
JulesGonin

Disclosure:Receivedroyaltyandconsultingfeesfor:AlconLaboratories.

ChiefEditor

HamptonRoy,Sr,MDAssociateClinicalProfessor,DepartmentofOphthalmology,Universityof
ArkansasforMedicalSciences

HamptonRoy,Sr,MDisamemberofthefollowingmedicalsocieties:AmericanAcademyof
Ophthalmology,AmericanCollegeofSurgeons,PanAmericanAssociationofOphthalmology

Disclosure:Nothingtodisclose.

AdditionalContributors

BrianAPhillpotts,MD,MD

BrianAPhillpotts,MD,MDisamemberofthefollowingmedicalsocieties:AmericanAcademyof
Ophthalmology,AmericanDiabetesAssociation,AmericanMedicalAssociation,NationalMedical
Association

Disclosure:Nothingtodisclose.

Acknowledgements

TeodoroEvans,MDConsultingSurgeon,VitreoRetinalSection,ClinicadeOjos,CostaRica

Disclosure:Nothingtodisclose.

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