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Endophthalmitis caused by intraocular lens haptic exposure on conjunctiva after intrascleral fixation using the Yamane flange technique: a case report Kou Yunoki 1 , Masashi Kimata 1 , Tadashi Mizuguchi 1 , Masayuki Horiguchi 1 , Yasuki Itou 1 1Department of Ophthalmology, Fujita Health University, School of Medicine pp.1259-1264
Published Date 2024/10/15
DOI https://doi.org/10.11477/mf.1410215301
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Abstract Purpose:Endophthalmitis due to external exposure of the intraocular lens(IOL)haptic is a known postoperative complication of IOL intrascleral fixation, but few cases have been reported to date. Here we report a case in which the IOL haptic was exposed on the conjunctiva, leading to endophthalmitis.

Case:Our patient was a 60-year-old man who underwent right IOL intrascleral haptic fixation at another hospital in October 2020. In January 2021, the IOL haptic became exposed on the conjunctiva and was re-implanted into the sclera, but re-exposure occurred in May 2021. Thereafter, the patient did not follow up at the hospital any further. In January 2023, the patient visited a nearby hospital with right eye pain and was referred to our hospital with suspected right endophthalmitis. At the first hospital visit, the corrected visual acuity in the right eye was 0.01 and the intraocular pressure was 29 mmHg. The IOL haptic was exposed on the conjunctiva at the 6 o'clock position, an empyema was visible in the anterior chamber, and the fundus had poor visibility. Vitrectomy, IOL extraction, and intravitreal antibiotic injection were performed on the same day. White deposits were observed in the removed IOL haptic, and Gram-positive cocci were detected in the anterior chamber aqueous humor. The patient was then treated with systemic antibiotics and three intravitreal injections. At three months postoperative, the corrected visual acuity in the right eye was 0.2 and the intraocular pressure was 20 mmHg, and there were no signs of infection.

Conclusion:In this case, the IOL haptic was exposed after use of the Yamane flange technique, and endophthalmitis occurred despite re-implantation. Similar reports include one case without support area exposure at three months postoperatively, and one case with support area exposure at six months postoperatively. In this case, although more than two years had passed since the surgery, the risk of infection remained high because the haptic was exposed downward. Clinicians must learn how to prevent and treat IOL haptic exposure.


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