Retina · Retinal surgery
IOL dislocation refers to the displacement of an intraocular implant placed during a previous operation, most often cataract surgery. The implant is no longer in its normal position, impairing vision and requiring specialised surgical revision.
During cataract surgery (or lens replacement), an intraocular implant is placed in the eye, in the position previously occupied by the natural lens. Dislocation refers to the situation when this implant shifts from its normal position, sometimes long after the initial procedure. Misaligned, it no longer fulfils its optical role properly and vision is affected.
This is an uncommon situation, but one that requires specialised surgery, at the interface between cataract and retinal surgery.
IOL dislocation can occur years after the initial surgery. Any deterioration or fluctuation in vision should prompt a consultation.
Dislocation is most often related to weakness of the structures supporting the implant. Several factors may contribute:
Signs that should prompt a consultation:
Ophthalmic examination determines the position of the implant and the condition of the eye's structures (implant support, retina), in order to plan the most appropriate revision surgery. This is where Dr Gattoussi's expertise in retinal surgery and ocular imaging is particularly valuable.
Treatment is surgical. It begins with a vitrectomy, which allows the structures of the eye and the implant's support to be assessed. When this support is sufficient, the implant is repositioned, sometimes sutured to the wall of the eye to stabilise it. When it is insufficient, the implant is removed and a new one is put in place, suited to the situation. This is specialised surgery.
When the implant and its support allow it, the implant can be returned to its correct position, possibly with fixation to stabilise it.
If the implant or its support do not permit reliable repositioning, the implant is removed and replaced with a new one suited to the situation.
Precise evaluation to choose the technique.
Vitrectomy, then repositioning or replacement of the implant depending on the support.
Check-ups to verify stability and recovery.
Most often due to weakness of the implant support, sometimes associated with high myopia, trauma, or the passage of time.
A deterioration in vision or discomfort following a knock should prompt a prompt consultation to assess the situation.
Recovery depends on the condition of the eye and the technique used. It is assessed on a case-by-case basis, with no guarantee of outcome.
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