Management of dislocated intraocular lenses.
OBJECTIVE
The purpose of this study was to characterize the contemporary clinical presentation and treatment results of patients with dislocated intraocular lenses (IOLs).


METHODS
Retrospective, noncomparative, single-surgeon interventional case series.


METHODS
Two hundred eighty-four eyes of 277 patients operated for dislocated IOLs; 184 eyes with >3 months follow-up information were analyzed for visual outcomes.


METHODS
Review of preoperative, intraoperative, and postoperative clinical features from patient charts.


METHODS
Best-corrected visual acuity, reoperations, and complications such as retinal detachment and postoperative refraction.


RESULTS
The study included eyes with polymethyl methacrylate IOLs (n = 113), silicone plate IOLs (n = 51), 3-piece silicone IOLs (n = 38), acrylic IOLs (n = 60), and others (n = 12). There were 51 (18%) with "in-the-bag" IOL dislocations; their proportion increased during the study period and were associated with pseudoexfoliation (P = 0.01), ocular trauma (P = 0.013), and time after implantation of IOL (P = 0.006). Recurrent dislocation (17 eyes; 6%) and decentration (11 eyes; 4%) of IOLs occurred, and resulted in further surgery in 18 (6%) eyes, but were not related to the types of IOL or surgical technique. The most common complication was cystoid macular edema (29 eyes; 10%); retinal detachment occurred after management of dislocated IOL in 11 (4%) eyes. Visual results and median postoperative refractive changes for the 184 eyes with follow-up >3 months were similar regardless of surgical techniques.


CONCLUSIONS
Currently, IOL dislocation more commonly involves foldable IOLs and in-the-bag dislocation. Existing techniques of IOL repositioning with or without scleral suture fixation or IOL exchange are effective for contemporary dislocated IOLs. Preexisting conditions and postoperative complications may limit the visual outcomes.
Kim
Sung Soo
SS
Department of Ophthalmology, Yongdong Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea.
Smiddy
William E
WE
Feuer
William
W
Shi
Wei
W
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005500:Follow-Up Studies; D005548:Foreign-Body Migration / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D007431:Intraoperative Complications; D007910:Lenses, Intraocular; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D012086:Reoperation; D012189:Retrospective Studies; D013536:Suture Techniques; D014792:Visual Acuity / Q000502:physiology