Rescue of a dislocated intraocular lens with silicone tip aspiration: a novel technique.

BACKGROUND: To evaluate the clinical efficacy of a novel surgical technique using a 25-gauge active aspiration of flute needle for treating the dislocation of posterior intraocular lens (IOL). METHODS: This retrospective study included 12 eyes in 12 patients with posterior dislocated IOL. All patients underwent comprehensive ophthalmic evaluations before surgery. Surgery was performed with three-port pars plana vitrectomy, the dislocated IOL was aspirated to the anterior vitreous by a 25-gauge flute needle, and then managed by different surgical corrections. Comprehensive ophthalmologic assessment was performed preoperatively and postoperatively, including best-corrected visual acuity (BCVA), intraocular pressure (IOP), slit-lamp biomicroscopy and fundus examination. Postoperative assessments were conducted at 1 week, 1 month, and 3 months. RESULTS: Twelve eyes were treated. All surgeries were successfully completed using a 25-gauge silicone tip with active aspiration. IOL repositioning without sutures in 1 case (8.3%), IOL repositioning with scleral sutures in 4 cases (33.3%), IOL exchanged with Yamane technique in 4 cases (33.3%) and IOL exchange with scleral sutures in 3 cases (25.0%). The mean follow-up time was 13.08 ± 5.49months (range 5–20 months). The mean BCVA preoperatively was log MAR 0.48 ± 0.33 (range 0.0-1.3), recovered to log MAR 0.34 ± 0.22 (range 0.0-0.7) at three-month postoperatively. The BCVA was improved at the three-month follow-up compared with preoperatively (t = 2.40, P = 0.035 < 0.05). IOP remained stable except for one patient who developed transient high IOP, but well controlled by medications. CONCLUSIONS: An active aspiration of flute needle with silicon tip provides a simplified, efficient and safe method for IOL dislocation, minimizing the needs of perfluorocarbon liquids as well as intraocular-forceps.