Cataract Surgery

Dislocated Lens

What are the causes of dislocated lens?

Sometimes the natural human lens, or an artificial lens implant, can become displaced causing blurred vision. This may be caused by:

  1. Inherited conditions (ectopia lentis): eg. Marfan’s syndrome.

  2. Trauma to the eyes.

  3. Complicated cataract surgery


What is Aphakia?

When there is no lens in the eye. This usually happens after the lens or lens implant is removed during the operation and not replaced for a specific reason.


What can be done if natural lens is displaced?

The displaced natural lens can be removed and usually combined with a vitrectomy. However, because the lens capsule is usually absent a lens implant cannot be placed in the usual way.


How can a lens implant be placed without a lens capsule?

There are various different technique, each with benefits and potential complications.

  • Anterior chamber lens implant (ACIOL): The lens is placed in front of the pupil, but can cause raised pressure (glaucoma) and damage to inner corneal endothelium layers in the long term. This lens is normally reserved for much older patients.

  • Artisan lens implant: a lens implant is placed in front of the pupil with tiny clips that attach the lens to the iris (coloured part surrounding the pupil). This requires a healthy iris, but may be associated with corneal damage long term.

  • Scleral haptic fixation of lens implant: The tiny loops attached to the lens (haptics) are attached to the inner aspect of the eye by tiny tunnels in the sclera. Sometimes this technique can be used with a displaced lens implant already in the eye, or a new lens can be implanted.

 
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