title: Incidence and risk factors of late in-the-bag intraocular lens dislocation: evaluation of 140 eyes between 1992 and 2012.
abstract: OBJECTIVE
  To identify risk factors for late in-the-bag intraocular lens (IOL) dislocation and estimate the incidence of this condition over a 21-year period.
  
  
  METHODS
  Department of Ophthalmology, County Hospital of Värmland, Karlstad, Sweden.
  
  
  METHODS
  Retrospective cohort study and nested case-control study.
  
  
  METHODS
  The medical records of eyes operated on for late in-the-bag IOL dislocation between 1992 and 2012 were reviewed. The annual incidence and cumulative risk were calculated.
  
  
  RESULTS
  Of 140 eyes whose records were reviewed, 123 qualified for comparison (24 variables) with an equal number in a control group. The annual incidence varied between 0.00% and 0.08%. An increasing trend was found (P < .001). The cumulative risk 5, 10, 15, and 20 years after cataract extraction was 0.09%, 0.55%, 1.00%, and 1.00%, respectively, and was significantly higher (P < .001) in eyes that had cataract surgery between 2002 and 2012 than in those operated on between 1992 and 2001 (0.89% versus 0.39% at 10 years postoperatively) (P < .001). Calendar time (date) of dislocation was positively correlated with the duration of preceding pseudophakia (P = .005). Phacoemulsification time was longer in eyes with dislocation than in control eyes (P < .001). Other identified risk factors were pseudoexfoliation, zonular dehiscence, pseudophacodonesis, and increased axial length.
  
  
  CONCLUSIONS
  The increasing number of late in-the-bag IOL dislocations cannot be explained by the growing pseudophakic population only. The increase in the incidence was due primarily to the longer duration of pseudophakia in the population and to a greater dislocation risk with recent cataract surgery. The increase in life expectancy played a minor role. Long phacoemulsification time was a risk factor for dislocation.
  
  
  BACKGROUND
  No author has a financial or proprietary interest in any material or method mentioned.
authors.affiliation: From the Department of Ophthalmology (Dabrowska-Kloda, Boudiaf), County Hospital of Värmland, Karlstad, the Department of Physics (Kloda), Stockholm University, Stockholm, and the Department of Ophthalmology (Jakobsson, Stenevi), Sahlgren University Hospital, Mölndal, Sweden. Electronic address: k.dabrowska.kloda@gmail.com.
authors.forename: Kinga
authors.initials: K
authors.lastname: Dabrowska-Kloda
authors.affiliation: From the Department of Ophthalmology (Dabrowska-Kloda, Boudiaf), County Hospital of Värmland, Karlstad, the Department of Physics (Kloda), Stockholm University, Stockholm, and the Department of Ophthalmology (Jakobsson, Stenevi), Sahlgren University Hospital, Mölndal, Sweden.
authors.forename: Tomasz
authors.initials: T
authors.lastname: Kloda
authors.affiliation: From the Department of Ophthalmology (Dabrowska-Kloda, Boudiaf), County Hospital of Värmland, Karlstad, the Department of Physics (Kloda), Stockholm University, Stockholm, and the Department of Ophthalmology (Jakobsson, Stenevi), Sahlgren University Hospital, Mölndal, Sweden.
authors.forename: Sara
authors.initials: S
authors.lastname: Boudiaf
authors.affiliation: From the Department of Ophthalmology (Dabrowska-Kloda, Boudiaf), County Hospital of Värmland, Karlstad, the Department of Physics (Kloda), Stockholm University, Stockholm, and the Department of Ophthalmology (Jakobsson, Stenevi), Sahlgren University Hospital, Mölndal, Sweden.
authors.forename: Gunnar
authors.initials: G
authors.lastname: Jakobsson
authors.affiliation: From the Department of Ophthalmology (Dabrowska-Kloda, Boudiaf), County Hospital of Värmland, Karlstad, the Department of Physics (Kloda), Stockholm University, Stockholm, and the Department of Ophthalmology (Jakobsson, Stenevi), Sahlgren University Hospital, Mölndal, Sweden.
authors.forename: Ulf
authors.initials: U
authors.lastname: Stenevi
mesh_terms: D000368:Aged; D060437:Artificial Lens Implant Migration / Q000453:epidemiology*; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D015994:Incidence; D007903:Lens Capsule, Crystalline; D007910:Lenses, Intraocular; D008297:Male; D018918:Phacoemulsification; D019591:Pseudophakia / Q000453:epidemiology; D012189:Retrospective Studies; D012307:Risk Factors; D013548:Sweden / Q000453:epidemiology