Presentation Characteristics and Surgical Management in 171 Cases of in-the-Bag IOL Dislocation
To evaluate the presentation characteristics and surgical outcomes of late in the bag IOL dislocation.
Retrospective (2005-2014) interventional case series including cases of late spontaneous in-the-bag IOL dislocation from two referral centers. The main outcome measures were interval between surgery and dislocation, dislocation site/grade, type of IOL, associated CTR, predisposing factors, surgical technique used to correct dislocation (repositioning using scleral fixation (SFIOL), iris suturing, IOL exchange for anterior chamber IOL (ACIOL), or iris–claw IOL (ICIOL), IOL removal and anterior capsulotomy), preoperative/postoperative corrected distance visual acuity (CDVA), and surgical complications.
In this series, 171 cases of in-the-bag IOL dislocation were identified of which 149 underwent surgery to correct IOL position. Pseudoexfoliation was the most common risk factor (76.02%). CTR was present within the capsular bag in 33 cases. Dislocation was corrected: 1) repositioning using SFIOL (73 cases) or iris suturing (1 case); 2) IOL exchange ACIOL (38 cases) or ICIOL (30 cases); 3) IOL removal (4 case); 4) capsulotomy (3 cases). Mean CDVA improved significantly after surgery (p=0.0001). There was no significant difference in postoperative CDVA between SFIOL, ACIOL and ICIOL.
Pseudoexfoliation was the main risk factor for in-the-bag IOL dislocation. A CTR within the bag did not prevent dislocation but facilitated IOL repositioning. Satisfactory results were achieved with a low rate of complications using different surgical alternatives to correct IOL position.