Surgical Correction for Late Postoperative Subluxation of a Diffractive Optic Multifocal IOL, Capsule Bag and Capsule Tension Ring Complex: Case Report

Samuel Masket

doi:10.1007/s40123-022-00478-y

Surgical Correction for Late Postoperative Subluxation of a Diffractive Optic Multifocal IOL, Capsule Bag and Capsule Tension Ring Complex: Case Report

Ophthalmol Ther. 2022 Apr;11(2):913-918. doi: 10.1007/s40123-022-00478-y. Epub 2022 Feb 26.

Author

Samuel Masket¹

Affiliation

¹ Stein Eye Institute Geffen School of Medicine Los Angeles, Advanced Vision Care, Suite 911, 2080 Century Park East, Los Angeles, CA, 90067, USA. avcmasket@aol.com.

Abstract

Diffractive optic intraocular lenses (IOLs) require near perfect centration for best performance. A patient with a multifocal IOL and pseudoexfoliation developed late marked subluxation of the capsule bag, capsule tension ring and multifocal IOL complex. The surgical challenge was to fixate and recenter the diffractive optic IOL in order to restore normal quality vision; traditional surgical methods are not adequate for repositioning IOLs of this nature. A unique surgical plan that included three-point radially oriented suture fixation of an existing standard capsule tension ring (CTR) was conceived and was successful in achieving the patient's goal of maintaining spectacle independence by returning his vision to previous levels with a well-centered multifocal IOL.

Keywords: Adjustable slip knot; Diffractive optic IOL; Malpositioned IOL; Multifocal IOL; Pseudoexfoliation; Radial suturing; Scleral suture fixation; Subluxated capsule bag/IOL/CTR complex.