title: SURGICAL OUTCOME OF LATE IN-THE-BAG INTRAOCULAR LENS DISLOCATION TREATED WITH PARS PLANA VITRECTOMY.
abstract: OBJECTIVE
  To present the visual outcome and postoperative complications of pars plana vitrectomy and intraocular lenses (IOL) removal with or without IOL exchange of late in-the-bag IOL dislocation after uneventful cataract surgery.
  
  
  METHODS
  Retrospective analysis of a consecutive series of 83 eyes with late in-the-bag dislocated IOL treated with pars plana vitrectomy and anterior chamber IOL (25 eyes), transscleral suture-fixated posterior chamber IOL (38 eyes), or aphakia (20 eyes).
  
  
  RESULTS
  High myopia was the major predisposing factor (40%). The interval between cataract surgery and the dislocation was 10.9 years. The complication rate after the second surgery was 43%; being transient hypotony (19%) and hypertension (15%) the most frequent. Postoperative best-corrected visual acuity improvement was statistically significant (P < 0.001), with a mean of 3 Snellen lines. This improvement was also significant in 2 subgroups, patients with sutured posterior chamber IOL (20/80-20/40; P < 0.001) and in patients with anterior chamber IOL (20/125-20/40; P < 0.001). However, best-corrected visual acuity did not improve in aphakic patients (20/63-20/63; P = 0.13). Postoperative astigmatism increased significantly (P < 0.001), with a mean of -1 D. Mean follow-up was 24 months.
  
  
  CONCLUSIONS
  The major predisposing factor for late in-the-bag IOL dislocation is myopia. Despite a complication rate of 43%, mostly minor and transient, IOL exchange surgery is an effective procedure with a good visual outcome (mean 3 Snellen lines improvement). There were no statistically significant differences in the final best-corrected visual acuity or complication rate between anterior chamber IOL and sutured posterior chamber IOL, thus, both surgical techniques may be considered to treat this condition.
authors.affiliation: Department of Ophthalmology, Institut Catala de Retina, Barcelona, Spain.
authors.forename: Amanda
authors.initials: A
authors.lastname: Rey
authors.forename: Ignasi
authors.initials: I
authors.lastname: Jürgens
authors.forename: Agnieszka
authors.initials: A
authors.lastname: Dyrda
authors.forename: Xavier
authors.initials: X
authors.lastname: Maseras
authors.forename: Antonio
authors.initials: A
authors.lastname: Morilla
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D060437:Artificial Lens Implant Migration / Q000503:physiopathology / Q000601:surgery*; D002648:Child; D002675:Child, Preschool; D020878:Device Removal; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D019654:Lens Implantation, Intraocular; D007910:Lenses, Intraocular; D008297:Male; D008875:Middle Aged; D047728:Myopia, Degenerative / Q000175:diagnosis; D011183:Postoperative Complications; D012086:Reoperation; D012189:Retrospective Studies; D013536:Suture Techniques; D014792:Visual Acuity / Q000502:physiology; D014821:Vitrectomy