Preoperative Evaluation of Cases with Aphakia and Intraocular Lens Dislocation by Ultrasound Biomicroscopy

The purpose of this study is to evaluate the capabilities of ultrasound biomicroscopy (UBM) as a diagnostic method for surgical planning of secondary intraocular lens (IOL) implantation in aphakia and intraocular lens dislocation. In this retrospective study, 19 eyes of 19 patients with aphakia and IOL dislocation that was not possible to evaluate by biomicroscopy because of the causes like corneal edema, opacity, anterior chamber reaction, ectopic pupil or poor pupil dilatation following cataract surgery were included. Ultrasound biomicroscopy was performed preoperatively to determine the capsule integrity, degree of ciliary sulcus support and iridocapsular adhesions. Seven patients with aphakia and 12 patients with posterior chamber IOL following cataract surgery were studied. Ultrasound biomicroscopy revealed that 4 of 7 eyes with aphakia had adequate capsule integrity (two eyes also had iridocapsular adhesions) and ciliary sulcus support, and 3 eyes had inadequate capsular remnant. Sulcus-supported posterior chamber IOLs were implanted in 4 eyes, and scleral-fixated posterior chamber IOLs were implanted in 3 eyes. Ultrasound biomicroscopy showed that 4 of 12 eyes with IOL dislocation had adequate capsule remnant, and there was no adequate capsular remnant and ciliary sulcus support in 8 eyes. IOL reposition or IOL exchange were performed in 4 eyes and IOL exchange and scleral-fixated posterior chamber IOLs implantation or scleral fixation of dislocated IOLs were performed in 8 eyes. In conclusion, ultrasound biomicroscopy helps the surgeon to select the appropriate surgical protocol by determining the capsule integrity, implant bed and iridocapsular adhesions preoperatively. It is also useful to choose the IOL model and its fixation type. [Med-Science 2015; 4(4.000): 2849-56