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A 37-year-old woman with spontaneous lens dislocation after vitrectomy for retinal reattachment
Digital Journal of Ophthalmology 2008
Volume 14, Number 5
February 10, 2008
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Konstantinos Chalioulias, MD, MRCOphth | Birmingham & Midland Eye Centre, UK
Aristeidis Konstantinidis, MD, MRCOphth | Coventry and Warwickshire University Hospital
Ioannis Athanasiadis | Coventry and Warwickshire University Hospital
Yajati K. Ghosh, MBBS, FRCSEd | Birmingham & Midland Eye Centre
Ajai K. Tyagi, FRCS, FRCOphth | Birmingham & Midland Eye Centre
The patient underwent uncomplicated vitrectomy, cryotherapy and 16% C3F8 gas injection under local anaesthetic. The operation was uneventful and no lens instability was noted peri-operatively. Her visual acuity on the first postoperative day was hand movements, there was mild anterior chamber reaction and the intraocular pressure was 26 mmHg. The lens was stable but we noted some mild posterior subcapsular opacities due to the presence of gas. The retina was attached and there was 80% fill of the vitreous cavity with gas.

Two weeks later, the visual acuity was hand movements in the right eye. The lens had dislocated to the inferior vitreous cavity, with recurrence of the retinal detachment (figure 1).

The patient underwent repeat vitrectomy, lensectomy to remove the dislocated lens, cryotherapy to a dialysis at 6 o’clock and 16% C3F8 gas tamponade. On the first postoperative day visual acuity was hand movements, there was moderate corneal edema and 80% fill of the vitreous cavity with gas.

Two months post-operatively the best corrected visual acuity is 6/12 in the right eye with aphakic correction. The plan for the patient is to perform a secondary intraocular lens implantation. There was no lens instability of the fellow eye during the whole period that the patient was under our care.
Figure 1
Lensectomy of the crystalline lens dislocated into the vitreous cavity