- Depends on haptics positioning and asymmetric bag-sulcus placement
during surgery.
- May develop later following eye injury, capsular or zonular disruption
and contracture.
- Clinical features:
- Intra ocular lens implant is not in its normal position.
- Symptoms: fluctuating vision, monocular diplopia, glare, halos,
photosensitivity and optical aberrations
- A sufficiently subluxated PCIOL may cause its optical zone to
no longer be in pupil and leave the visual axis aphakic
- Sunrise syndrome:
Most commonly occurs due to the misplacement of the superior haptic
in the ciliary sulcus, while the inferior one is placed into the capsular
bag that allows the IOL to subluxate superiorly.
- Sunset syndrome:
- May result from undetected anterior capsule rupture extending
inferiorly allowing the inferior haptic of PCIOL to escape through
the defect.
- Management:
- Repositioning the implant superiorly.
- Moving the lens from the capsular bag to the sulcus.
- Placing the optical portion in front of the iris.
- Creating a pupillary capture.
- Rarely it has to be removed or replaced with secondary AC
IOL implantation.
- Iris- or transcleral-sutures may be required to secure the
IOL in position.
- East-west or horizontal decentration well as posterior and anterior
dislocation may also be encountered.
|
