FEB 27, 2023
AAO 2022 Video Program
Retina/Vitreous, Vitreoretinal Surgery
This video presents a case of traumatic suprachoroidal dislocation of the crystalline lens. A 22-year-old man presented for vision loss after blunt trauma. Pars plana vitrectomy (PPV) showed aphakia; an iris defect; a round, convex, smooth elevation at the superior retina; and no retinal breaks. Oil tamponade was used. Eight weeks later, the convex elevation was unchanged and suspected to be a subretinal dislocated lens. Raised intraocular pressure, oil-fill in a young eye, and uncertain visual prognosis prompted a second PPV; an intraocular approach was chosen given the suspected lens location. A circumferential superior retinal incision of 2 clock hours was performed. The lens was in the suprachoroidal space, visible through a small, preexisting choroidal defect, which was enlarged with vitreoretinal scissors. The lens was explanted with a bimanual approach and removed with the cutter, and retinopexy and oil tamponade were performed. Hematoxylin-eosin staining confirmed the diagnosis. Traumatic suprachoroidal lens dislocation has been reported once without histologic confirmation. The presenters believe the lens reached the suprachoroidal space through the large iris defect.
Financial Disclosure: Drs. Kurt Cornish, Piertgiacomo Grassi, and Yashin Ramkissoon disclose no financial relationships.