Results of Pars Plana Vitrectomy and Scleral-fixated Intraocular Lens Implantation in the Same Session

Objective: To assess the outcomes of pars plana vitrectomy (PPV) and scleral-fixated intraocular lens (SFIOL) implantation which posteriorly dislocated intraocular lens (IOL) and nucleus drop. Methods: Twenty four eyes of 24 patients that were implanted by PPV and SFIOL between January 2013 and January 2015 were retrospectively evaluated. Pre- and postoperative findings and complications were evaluated. Results: The mean age was 65.75+/-13.44 (32-87). The mean follow-up time was 21.29+/-7.17 (9-33) months. Fourteen patients were operated by IOL dislocation and 10 by nucleus or partial nucleus drop. Six dislocated IOLs were foldable one part, 6 foldable three parts, and 2 PMMA lenses. In IOL dislocations, 7 patient's own IOLs; in 7 patients, a new IOL is fixed to the sclera. One-sided scleral fixation was applied to 9 patients. IOL implementation was applied to 9 patients by opening the scleral flap and to 15 patients by not opening the scleral flap. When the postoperative corrected visual acuities of the patients were compared with the preoperative corrected visual acuities, the mean visual acuity increased by 0.2 or more in 12 patients (50%) with Snellen acuity card, remained the same in 8 patients (33.30%), and decreased in 4 patients (16.6%). Postoperatively, retinal detachment was noted 1 patient (4.15%), increased intraocular pressure in 2 (8.30%), suture exposure in 4 (16.66%), and cystoid macular edema in 2 (8.30%). Hypotonia, choroid detachment, and endophthalmitis were not detected. Conclusion: In nucleus drop and IOL dislocation, PPV and SFIOL implementation should be attentively performed by taking into account serious complications in patients lacking capsular support.