Management of retinal detachments in pseudophakic patients with Artisan lenses

Purpose: To report the management and outcomes of retinal detachment repair in patients with Artisan intraocular lenses (IOLs) used for pseudophakic correction. Setting. Two university-based referral centers. Methods: In this retrospective case-control study, all cases of retinal detachments in patients with an Artisan IOL used for pseudophakic correction were reviewed over 5 years at 2 university clinics. Results. Of the 20 patients identified, all had a detachment in 2 or more quadrants. A retinal tear was identified in 19 patients preoperatively. Thirteen patients had a standard buckling procedure, 3 with the addition of gas; 3 required a pars plana vitrectomy; and 2 were treated with pneumatic retinopexy alone. Reattachment was achieved with 1 procedure in 11 patients, with 2 procedures in 5 patients, and with 3 procedures in 3 patients; reattachment could not be achieved in 2 cases. Anterior displacement of the lens was noted when gas tamponade was used. When the displacement was significant, sodium hyaluronate 1% (Healon(R)) was used to prevent corneal endothelial touch. Conclusions: In most cases, the Artisan lens did not significantly limit peripheral retinal visibility. Standard buckling procedures were generally successful. Given the limited support provided by the iris, the presence of gas in the vitreous cavity can lead to anterior displacement of the lens. Corneal endothelial touch can be prevented by the use of Healon, which is sufficient if short-term gas tamponade is used. (C) 2002 ASCRS and ESCRS