title: Surgical repositioning of intraocular lenses after late dislocation: complications, effect on intraocular pressure, and visual outcomes.
abstract: OBJECTIVE
  To study outcomes after surgery for late intraocular lens (IOL) dislocation and, more specifically, to evaluate different surgical techniques to find predictors of worse visual outcomes, describe postoperative complications, and analyze the effect on intraocular pressure (IOP).
  
  
  METHODS
  Department of Ophthalmology, Sahlgrenska University Hospital, Mölndal, Sweden.
  
  
  METHODS
  Prospective observational cohort study.
  
  
  METHODS
  Medical records from cataract surgery, IOL repositioning, and follow-up examinations were reviewed.
  
  
  RESULTS
  Ninety-one eyes with in-the-bag (80) or out-of-the-bag (11) late IOL dislocation were consecutively included. In 94% of eyes, the IOLs were repositioned using scleral sutures; 76% of cases were operated on with a posterior approach, including pars plana vitrectomy. The median follow-up was 17 months. Pseudoexfoliation was detected in 57% of eyes. A significant decrease in IOP (mean 3.0 mm Hg) from preoperative values (P=.028) was seen in glaucoma patients. Thirteen eyes had additional surgical procedures. Three cases of retinal detachment occurred. Of the eyes, 59% obtained a Snellen corrected distance visual acuity (CDVA) of 0.5 or more at follow-up; 23% of eyes had worse CDVA during the follow-up than preoperatively.
  
  
  CONCLUSIONS
  Repositioning surgery for late IOL dislocation with a posterior pars plana approach using scleral suturing of the preexisting IOL appears to be a safe and effective method for restoring visual acuity. Postoperative complications were comparable to previous findings in this field. Patients with glaucoma may have improved IOP regulation.
authors.affiliation: From the Institute of Neuroscience and Physiology, Section of Clinical Neuroscience and Rehabilitation/Ophthalmology, Sahlgrenska Academy, University of Gothenburg, Mölndal, Sweden. Electronic address: gunnar.jakobsson@vgregion.se.
authors.forename: Gunnar
authors.initials: G
authors.lastname: Jakobsson
authors.forename: Madeleine
authors.initials: M
authors.lastname: Zetterberg
authors.forename: Karin
authors.initials: K
authors.lastname: Sundelin
authors.forename: Ulf
authors.initials: U
authors.lastname: Stenevi
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D060437:Artificial Lens Implant Migration / Q000209:etiology / Q000503:physiopathology / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007429:Intraocular Pressure / Q000502:physiology*; D019654:Lens Implantation, Intraocular; D008297:Male; D008875:Middle Aged; D013508:Ophthalmologic Surgical Procedures; D018918:Phacoemulsification; D011183:Postoperative Complications; D011446:Prospective Studies; D012086:Reoperation; D013536:Suture Techniques; D014792:Visual Acuity / Q000502:physiology*