J Korean Ophthalmol Soc.  2016 Sep;57(9):1493-1497. 10.3341/jkos.2016.57.9.1493.

A Case of Acute Angle Closure Caused by Dislocation of Accommodative Intraocular Lens

• Hwang HJ
• Hwang YH
• Lee JJ
• Kim BY

• KMID: 2351885
• DOI: http://doi.org/10.3341/jkos.2016.57.9.1493

Abstract

PURPOSE
To report a case of acute angle closure after cataract surgery using an accommodative intraocular lens (IOL), WIOL-CF® (GELMED, Praha, Czech).
CASE SUMMARY
A 46-year-old male patient underwent phacoemulsification and implantation of WIOL-CF® into the capsular bag. Seven months after the surgery, a sudden increase in intraocular pressure (IOP) associated with angle closure was observed. Ultrabiomicroscopy revealed a dislocated WIOL-CF® that was pushing the peripheral iris anteriorly. Despite the use of IOP-lowering medication and peripheral laser iridotomy, IOP was not controlled. After the use of cycloplegics, the angle was widened and IOP decreased; however, after nine days, the WIOL-CF® was completely dislocated into the anterior chamber and so was removed.
CONCLUSIONS
When performing cataract surgery using WIOL-CF®, a possibility of dislocation of IOL and subsequent angle closure should be considered.

Keyword

Accommodative intraocular lens; Angle closure; Cataract; Glaucoma; WIOL-CF®

MeSH Terms

Anterior Chamber
Cataract
Dislocations*
Glaucoma
Humans
Intraocular Pressure
Iris
Lenses, Intraocular*
Male
Middle Aged
Mydriatics
Phacoemulsification
Mydriatics

Figure

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  Figure 1. Profile of accommodative intraocular lens, WIOL-CF®(GELMED, Praha, Czech).

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  Figure 2. Ultrasound biomicroscopic findings of superior (S), nasal (N), inferior (I), and temporal (T) angle at the time of acute angle closure. White arrow indicates anterior surface of intraocular lens (IOL), white arrowhead indicates posterior surface of IOL, and black arrowheads indicate anterior angle. IOL was dislocated from capsular bag and dislocated IOL was pushing peripheral iris anteriorly. Anterior angles were closed in all quadrants due to anterior displacement of IOL.

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  Figure 3. Ultrasound biomicroscopic findings of superior (S), nasal (N), inferior (I), and temporal (T) angle after the instillation of cycloplegics. White arrow indicates anterior surface of intraocular lens (IOL), white arrowhead indicates posterior surface of IOL, and black arrowheads indicate anterior angle. IOL moved posteriorly and anterior angle was widened compared to the previous state.

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  Figure 4. Slit-lamp photograph 9 days after the instillation of cycloplegics. Intraocular lens was completely dislocated into the anterior chamber. White arrows indicate margin of intraocular lens.

Reference

References

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