Late dislocation of in-the-bag and out-of-the bag intraocular lenses: ocular and surgical characteristics and time to lens repositioning.
OBJECTIVE
To characterize patients with late intraocular lens (IOL) dislocation to evaluate possible risk factors, determine the time between cataract surgery and IOL repositioning, describe the surgical management, and estimate the incidence.


METHODS
Department of Ophthalmology, Sahlgrenska University Hospital, Mölndal, Sweden.


METHODS
Case series.


METHODS
Medical records from the cataract surgery and IOL repositioning were reviewed.


RESULTS
The study enrolled 84 eyes, 63 with in-the-bag IOL dislocation and 21 with out-of-the-bag IOL dislocation. The prevalence of pseudoexfoliation (PXF) was 60% and of glaucoma, 36%. A high proportion of eyes with IOL dislocation (37%) had zonular dehiscence at cataract surgery. The median time from cataract surgery to IOL repositioning surgery was significantly shorter in eyes with out-of-the-bag IOL dislocation (3.2 years) than in eyes with in-the-bag IOL dislocation (6.7 years) (P = .029). The interval was also significantly shorter in eyes with zonular dehiscence. Using data from the National Cataract Register, the calculated incidence of IOL repositioning surgery per pseudophakic individuals in western Sweden was 0.050%.


CONCLUSIONS
The possible major predisposing factors for late IOL dislocation were PXF, glaucoma, and cataract surgery complicated by zonular dehiscence. Primary placement of the IOL in the ciliary sulcus was associated with earlier IOL dislocation. Intraocular lens repositioning surgery using a posterior or anterior approach was successful in many cases. FINANCIAL
Jakobsson
Gunnar
G
Department of Clinical Neuroscience and Rehabilitation/Ophthalmology, Institute of Neuroscience and Physiology, Section of Clinical Neuroscience and Rehabilitation/Ophthalmology, Sahlgrenska Academy, University of Gothenburg, Mölndal, Sweden. gunnar.jakobsson@vgregion.se
Zetterberg
Madeleine
M
Lundström
Mats
M
Stenevi
Ulf
U
Grenmark
Richard
R
Sundelin
Karin
K
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D015994:Incidence; D019654:Lens Implantation, Intraocular; D007910:Lenses, Intraocular; D008297:Male; D008875:Middle Aged; D011475:Prosthesis Failure; D019591:Pseudophakia / Q000503:physiopathology; D012086:Reoperation; D013548:Sweden / Q000453:epidemiology; D013997:Time Factors; D014792:Visual Acuity / Q000502:physiology