DR. ROHIT AGRAWAL

, Dr. PALAK CHIRANIYA, Dr. O.P. AGRAWAL

Abstract

This patient was referred by a cataract surgeon with the h/o of OS cataract surgery with PCR with IOL drop. On examination, IOL with mild VH was seen inferiorly in vitreous cavity.

But surprisingly, there were 2 IOLs in the vitreous cavity lying one over another!

Under all aseptic precautions, 3 port 25G pars plana vitrectomy was started, it was noticed that patient had not one, but two IOLs dislocated in vitreous cavity.

Both the IOLs were engaged to each other (“conjoint twins”) at the vitreous base.

Scleral tunnel was reopened. With the help of a Alcon 25G forceps, Both the IOLs were lifted one by one in the anterior-vitreous cavity and explanted through the scleral tunnel. Following this iris claw lens was implanted. Post-operatively, lens was well centered. Patients vision improved to 6/9 partial.

For the cases of IOL drop, a complete and thorough vitrectomy is necessary. Before explanting the lens PVD must be induced to prevent traction over retina and avoid retinal breaks.