title: Late in-the-bag intraocular lens dislocation requiring explantation: risk factors and outcomes.
abstract: OBJECTIVE
  To study the predisposing factors for late in-the-bag intraocular lens (IOL) dislocation and to analyze the outcomes after explantation surgery.
  
  
  METHODS
  In this retrospective multicentre study, 61 eyes were enrolled. The main inclusion criterion was in-the-bag spontaneous IOL dislocation after uneventful phacoemulsification cataract extraction. Only eyes with serious dislocation that required IOL explantation were eligible. Follow-up after explantation surgery of at least 3 months was required. Exclusion criteria were complicated cataract surgery, out-of-the-bag IOL dislocation, and dislocations that occurred in the first year after the cataract surgery. The main outcome measures were predisposing factors for dislocation, interval between cataract surgery and dislocation, surgical treatment at the time of explantation, preoperative and postoperative corrected distance visual acuity (CDVA), and postoperative complications.
  
  
  RESULTS
  High myopia was detected in 12 cases (19.7%) and it was the main predisposing factor. Mean time interval from cataract surgery to dislocation was 7.5 (SD 5.2) years. The dislocated in-the-bag IOL was replaced with a scleral fixated IOL (36.1%), angle-supported anterior chamber IOL (31.1%), sulcus repositioning (18%), or posterior chamber iris sutured IOL (4.9%). Finally, 9.8% of the patients were left aphakic. Mean CDVA improved significantly after surgery (P=0.005). Final CDVA of 20/40 or better was achieved in 29 cases (47.5%).
  
  
  CONCLUSIONS
  High myopia was the main risk factor for late in-the-bag IOL dislocation. Surgical treatment significantly improved the CDVA in our sample and was associated with a low complication rate.
authors.affiliation: Vissum Corporation, Alicante, Spain.
authors.forename: R
authors.initials: R
authors.lastname: Fernández-Buenaga
authors.forename: J L
authors.initials: JL
authors.lastname: Alio
authors.forename: A L
authors.initials: AL
authors.lastname: Pérez-Ardoy
authors.forename: A
authors.initials: A
authors.lastname: Larrosa-Quesada
authors.forename: L
authors.initials: L
authors.lastname: Pinilla-Cortés
authors.forename: R
authors.initials: R
authors.lastname: Barraquer
authors.forename: J L
authors.initials: JL
authors.lastname: Alio
authors.forename: F J
authors.initials: FJ
authors.lastname: Muñoz-Negrete
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D020878:Device Removal; D005260:Female; D006801:Humans; D007906:Lens Subluxation / Q000209:etiology* / Q000601:surgery; D007910:Lenses, Intraocular; D008297:Male; D008875:Middle Aged; D009216:Myopia / Q000150:complications; D017063:Outcome Assessment, Health Care; D018918:Phacoemulsification; D011183:Postoperative Complications / Q000209:etiology; D012086:Reoperation; D012189:Retrospective Studies; D012307:Risk Factors; D014792:Visual Acuity