[Cause analysis and management of severe dislocated or subluxated intraocular lenses in the capsular bag].
OBJECTIVE
To analyze the causes of severe dislocated and subluxated intraocular lenses (IOL) in capsular bag and the relevancy with abnormal capsular constitution.


METHODS
The abnormality of capsular and the position of IOL were retrospectively analyzed by slit lamp and microscope in dilated pupil. Surgeries were performed in all of 31 cases in order to exchange or reposit the dislocated or subluxated lOL.


RESULTS
Among 31 cases, there were 20 cases with the dislocated or subluxated IOL in the earlier postoperative period and 11 cases in the later postoperative period. The subluxated IOL in 5 cases (16.1%) were caused by the large rupture of the posterior capsular, and by the rupture of the posterior capsular in 9 cases (29.0%). A upward subluxated IOL developed in one case (3.2%) as the result of small rupture in the equater capsular. The subluxatd IOL in the anterior chamber in two cases (6.5%) was induced by the radial rupture of residual anterior capsular. The size of the IOLs in 2 cases were not matched to the diameter of the capsule bag. The dislocated IOL into the vitreous in 2 cases was caused by the rupture of the superior capsular. The subluxated IOL in 2 cases (6.5%) was caused by the zonal finers rupture due to trauma. The severe disfiguration of the IOL haptic was found in one case. The dislocated IOL in 6 cases (19.4%) was caused by asymmetric capsular shrinkage. A subluxated IOL in one case was resulted from the zonular defects with pseudoexfoliation syndrome. The postoperative corrected visual acuity was 0.5 - 1.0 in 24 eyes, 0.1 - 0.4 in 6 eyes, and 0.05 in one eye.


CONCLUSIONS
There are several causes for the dislocated or subluxated IOL. The correction of the IOL position should depend on the cause for the dislocated or subluxated IOL.
Wang
Wen-qing
WQ
Department of Ophthalmology, Sixth People's Hospital of Shanghai Jiaotong University, Shanghai 200233, China. WWQ2199@yahoo.com.cn
Jia
Li-Li
LL
Lu
Bin
B
Fang
Jian
J
Chen
Ying
Y
D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D007903:Lens Capsule, Crystalline / Q000473:pathology* / Q000601:surgery; D019654:Lens Implantation, Intraocular / Q000009:adverse effects; D007906:Lens Subluxation / Q000209:etiology* / Q000601:surgery; D007910:Lenses, Intraocular; D008297:Male; D008875:Middle Aged; D018918:Phacoemulsification / Q000009:adverse effects; D011183:Postoperative Complications; D012189:Retrospective Studies