Diffuse Intraretinal and Optic Disc Edema in a Case of Reversed Vaulted Sulcus-Implantation of a Multi-Piece Intraocular Lens in a 7-Year-Old Child

Abstract

Objective: This paper reports a rare presentation of diffuse intraocular inflammation following reversed vaulted multipiece intraocular lens (IOL) implanted in the sulcus of a 7-year-old child.

Methods: This is a case report.

Case presentation: A 7-year-old child presented with persistent posterior pole inflammation and optic disc swelling after an improperly placed multipiece intraocular lens in the sulcus. Comprehensive eye and wholebody evaluations were performed with the aid of optical coherence tomography (OCT), magnetic resonance imaging (MRI) and systemic work-up to rule out other causes of uveitis to definitively diagnose the case. The reverse-vaulted lens was eventually explanted. After 1 week post-explantation, the visual acuity improved markedly to 20/100 with the appropriate spectacle prescription. The patient recovered from the ocular inflammation 8 months postoperatively.

Conclusion: This paper reports significant posterior pole inflammation as an uncommon yet potentially visually-disabling consequence of a reverse-vaulted sulcus placement of a multipiece intraocular lens in a child. Careful attention is warranted to ensure proper IOL orientation during implantation, especially in pediatric cataract surgery. Visual rehabilitation is important postoperatively