To report a case with recurrent Irvine Gass syndrome associated with an incarcerated anterior chamber intraocular lens (ACIOL) and two sunken posterior chamber intraocular lens (PCIOL).
Methods
Observational case report with comprehensive chart review
Results
This is a 57 year-old female patient who complained about blurred vision of right eye for 1year. According to the patient, she had received cataract surgery and followed by 2 times of intraocular lens implantation surgery 2 years ago. The best corrected visual acuity (BCVA) of right eye at first visit was 0.1. Slit lamp exam revealed clear cornea and ACIOL with vitreous strand. The fundus exam showed macular edema with central retinal thickness of 343um by optical coherence tomography (OCT). Fluorescent angiography showed cystoid macular edema (CME) with severe leakage. The patient received intravitreal injection of aflibercept and the BCVA improved to 0.7. The OCT showed great improvement in CME. However, two months after 1st injection of aflibercept, the BCVA dropped to 0.25 and recurrent CME was noted. She received 2nd injection of aflibercept and the BCVA improved again. However, 3 months after 2nd injection, her BCVA dropped to 0.315 and recurrent CME was noted. The patient was then received the 3rd injection and pars plana vitrectomy to remove the vitreous strand 2 weeks after the 3rd injection. However, two sunken PCIOL were found during the vitrectomy and was then removed during surgery.
Conclusion
This is a rare case of recurrent Irvine Gass syndrome with 2 dislocated IOL which was not noticed preoperatively. In cases with frequent recurrent Irvine Gass syndrome, further exam should be done to exclude other possibility.
Conflict of interest
No
Author 1
Last name
KAO
Initials of first name(s)
T.Y.
Department
Ophthalmology
City
Taipei
Country
Taiwan
Author 2
Last name
Cheng
Initials of first name(s)
C.K.
Department
Ophthalmology
City
Taipei
Country
Taiwan
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