Purpose:

To assess the rhegmatogenous retinal detachment with crystalline lens dislocation and discuss appropriate surgical techniques.

Material and Method:

The surgical technique and clinical approach in five patients with rhegmatogenous retinal detachment and crystalline lens dislocation were assessed. Four patients were male and one was female. Encircling scleral buckling surgery was performed 12 mm from the limbus in all cases. In order to visualize the vitreous body, triamcinolone acetonide was injected into the vitreous cavity and then vitrectomy was carried out. Perfluorodecaline (DK Line) was injected to elevate the dislocated lens to the iris level. The lens material was aspirated by pars plana phacofragmentation and cortex remnants were cleaned by vitrectomy. Laser endophotocoagulation was performed 360 degree on the peripheral retina through the perfluorodecaline. Six o’clock peripheral iridectomy was done and dispersive viscoelastic material was injected into the anterior chamber. Then perfluorodecaline was exchanged with 1300 cs silicone oil.

Result:

The mean age of the subjects was 29 years (range, 26-33 years). The patients were followed for a mean period of 68 months (range, 56-86 months). The cause of crystalline lens dislocation was trauma in two cases and Marfan syndrome in three cases. The mean preoperative best-corrected visual acuity was less than 1/10. Visual acuity increased postoperatively in all eyes; the mean visual acuity was 1/10. In the follow-up period, retina was attached in all cases. As silicone oil was injected in all cases, intraocular lens insertion was not performed.

Discussion:

Perfluorocarbon liquids used in the crystalline lens dislocation with rhegmatogenous retinal detachment can either flatten the retina or lift the dislocated lens to the iris plane and decrease endophacoemulsification-related complications.

Keywords: Crystalline lens dislocation, pars plana vitrectomy, phacofragmentation, retinal detachment