Sunrise Syndrome

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Original article contributed by:

Marianna Kavalaraki MD, Msc

All contributors:

Alexandra Kavalaraki, Alpa S. Patel, M.D., Marianna Kavalaraki MD, Msc

Assigned editor:

Brandon Baartman, MD

Review:

Assigned status Update Pending

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Sunrise syndrome : superior IOL subluxation with superior haptic in the ciliary sulcus and inferior haptic place in the bag. Source: Columbia University, Department of Ophthalmology

Sunrise syndrome and Sunset syndrome are IOL-related cataract surgery complications. resulting from malposition of the IOL.

Disease Entity

Disease

The term Sunrise Syndrome and/or Sunset Syndrome refers to the IOL-associated cataract complication, which often occurs early due to improper IOL fixation within the secure capsular bag, resulting in IOL misplacement . It depends on haptics positioning and asymmetric bag-sulcus placement. Both can present later following ocular injury, capsular or zonular disruption and contracture. Sunset syndrome most commonly occurs due to the misplacement of the superior haptic in the ciliary sulcus, while the inferior one is placed into the capsular bag, that allows the IOL to subluxate superiorly. Depends on haptics positioning and asymmetric bag-sulcus placement during surgery. Sunset syndrome can develop from undetected anterior capsule rupture extending inferiorly allowing the inferior haptic of PCIOL to escape through the defect, leading to downward IOL displacement.

Sunset syndrome : inferior IOL subluxation with the inferior haptic escaping through the anterior capsule rupture defect. Source : University of Columbia, Department of Ophthalmology

Diagnosis

Symptoms

• fluctuating vision
• monocular diplopia
• glare
• halos
• photosensitivity
• optical aberrations

Management

Surgery

• Repositioning the implant superiorly.
• Moving the lens from the capsular bag to the sulcus.
• Placing the optical portion in front of the iris.
• Creating a pupillary capture.
• Rarely it has to be removed or replaced with secondary AC IOL implantation.
• Iris- or transcleral-sutures may be required to secure the IOL in position.

Sunrise Syndrome. Source : Textbook of Ophthalmology, Diseases of the Lens, Jaypee Brothers Medical Publishers (P) Ltd. 2012/01/01. E Nema HV. E Nema Nitin