Subluxated IOL-Bag Complex in a Challenging Case

Dr. Gennady Landa manages a 78-year-old patient with non-clearing vitreous hemorrhage due to uveitis-glaucoma-hyphema syndrome and a subluxated IOL-bag complex. The patient’s past ocular history was remarkable for pseudoexfoliative glaucoma and several corneal procedures, including penetrating keratoplasty and a recent DSAEK. In this case, it was important to avoid any corneal incisions due to the risk of endothelial lenticule graft dislocation and subsequent corneal decompensation. This video demonstrates how to perform a one-stage approach that includes pars plana vitrectomy, IOL-bag complex removal, and implantation a new IOL using the double-needle flanged haptic technique first described by Dr. Shin Yamane. While the patient’s visual acuity was subjectively better postoperatively, his visual potential is limited due to preexisting macular atrophic changes and advanced glaucoma. 

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