Decentration of a toric intraocular lens implant in a patient with simple megalocornea

Purpose: To describe a patient who developed radial displacement of the capsular bag and toric intraocular lens implant within approximately 5 weeks after surgery. Observations: A patient underwent uncomplicated cataract extraction and implantation of a toric IOL for 2.5 diopters (D) of preoperative...

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Main Author: Irene C. Kuo
Format: Article
Language:English
Published: Elsevier 2020-09-01
Series:American Journal of Ophthalmology Case Reports
Subjects:
Online Access:http://www.sciencedirect.com/science/article/pii/S2451993620301055
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spelling doaj-a5a6daee212d4dcdac9f9d12952e8c6b2020-11-25T03:54:23ZengElsevierAmerican Journal of Ophthalmology Case Reports2451-99362020-09-0119100754Decentration of a toric intraocular lens implant in a patient with simple megalocorneaIrene C. Kuo0Wilmer Eye Institute, Department of Ophthalmology, Johns Hopkins University School of Medicine, 4924 Campbell Blvd. #100, Baltimore, MD, 21236, USAPurpose: To describe a patient who developed radial displacement of the capsular bag and toric intraocular lens implant within approximately 5 weeks after surgery. Observations: A patient underwent uncomplicated cataract extraction and implantation of a toric IOL for 2.5 diopters (D) of preoperative corneal astigmatism. Uncorrected visual acuity (UCVA) on postoperative day 1 was 20/20. Blurriness developed 5 weeks after surgery when UCVA was 20/70 but corrected to 20/20 with 2 D of cylinder in a new axis. The IOL was in the proper axis, but it and the capsular bag were radially displaced. Dilated examination revealed posterior capsular opacification superotemporally, outside the visual axis. The patient's biometry revealed axial myopia and megalocornea (white-to-white measurement of 13.44 mm), suggesting a larger than average capsular bag. Surgery was performed at postoperative week 6 to expand the capsular bag using a capsular tension ring and to re-center the IOL keeping the same axis. The patient recovered UCVA of 20/25 after the IOL was recentered. Conclusions and Importance: It is important to review biometry for large white-to-white measurements. Eyes with megalocornea may require capsular tension rings at time of toric IOL implantation so as to maintain IOL centration and good UCVA.http://www.sciencedirect.com/science/article/pii/S2451993620301055Toric lens implantMegalocorneaCataract surgeryCapsular tension ringCapsular bagWhite-to-white
collection DOAJ
language English
format Article
sources DOAJ
author Irene C. Kuo
spellingShingle Irene C. Kuo
Decentration of a toric intraocular lens implant in a patient with simple megalocornea
American Journal of Ophthalmology Case Reports
Toric lens implant
Megalocornea
Cataract surgery
Capsular tension ring
Capsular bag
White-to-white
author_facet Irene C. Kuo
author_sort Irene C. Kuo
title Decentration of a toric intraocular lens implant in a patient with simple megalocornea
title_short Decentration of a toric intraocular lens implant in a patient with simple megalocornea
title_full Decentration of a toric intraocular lens implant in a patient with simple megalocornea
title_fullStr Decentration of a toric intraocular lens implant in a patient with simple megalocornea
title_full_unstemmed Decentration of a toric intraocular lens implant in a patient with simple megalocornea
title_sort decentration of a toric intraocular lens implant in a patient with simple megalocornea
publisher Elsevier
series American Journal of Ophthalmology Case Reports
issn 2451-9936
publishDate 2020-09-01
description Purpose: To describe a patient who developed radial displacement of the capsular bag and toric intraocular lens implant within approximately 5 weeks after surgery. Observations: A patient underwent uncomplicated cataract extraction and implantation of a toric IOL for 2.5 diopters (D) of preoperative corneal astigmatism. Uncorrected visual acuity (UCVA) on postoperative day 1 was 20/20. Blurriness developed 5 weeks after surgery when UCVA was 20/70 but corrected to 20/20 with 2 D of cylinder in a new axis. The IOL was in the proper axis, but it and the capsular bag were radially displaced. Dilated examination revealed posterior capsular opacification superotemporally, outside the visual axis. The patient's biometry revealed axial myopia and megalocornea (white-to-white measurement of 13.44 mm), suggesting a larger than average capsular bag. Surgery was performed at postoperative week 6 to expand the capsular bag using a capsular tension ring and to re-center the IOL keeping the same axis. The patient recovered UCVA of 20/25 after the IOL was recentered. Conclusions and Importance: It is important to review biometry for large white-to-white measurements. Eyes with megalocornea may require capsular tension rings at time of toric IOL implantation so as to maintain IOL centration and good UCVA.
topic Toric lens implant
Megalocornea
Cataract surgery
Capsular tension ring
Capsular bag
White-to-white
url http://www.sciencedirect.com/science/article/pii/S2451993620301055
work_keys_str_mv AT ireneckuo decentrationofatoricintraocularlensimplantinapatientwithsimplemegalocornea
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