Surgical Management of Subluxed Posterior-Chamber Intraocular Lenses

OBJECTIVE: To formulate a systematic approach to the surgical management of subluxed posterior-chamber intraocular lenses (IOLs). DESIGN: We reviewed the records of 31 consecutive patients who underwent anterior-segment surgery for IOL subluxation. Presumed anatomic causes of IOL subluxation were identified in 28 cases (90%). Three surgical procedures were used to correct the implant subluxation: modified McCannel sutures (19 eyes), IOL exchange (eight eyes), or IOL rotation (four eyes). RESULTS: Twenty-nine (94%) of the 31 patients obtained a postoperative visual acuity of 20/40 or better. Surgical complications included persistent vitreous in the anterior chamber (three cases), progressive capsular opacification (two cases), and anterior chamber and vitreous hemorrhage (one case). CONCLUSIONS: Our results show that, by implementing a planned surgical approach, subluxed posterior-chamber IOLs can be safely and effectively managed.