Clinical Characteristics of Intraocular Lens Dislocation in Chinese Han Populations.

Qi Fan,Xiaoyan Han,Xiaodi Qiu,Lei Cai,Jin Yang,Xiangjia Zhu,Yi Lu

doi:10.1155/2020/8053941

Abstract

Purpose To investigate the clinical characteristics of patients with intraocular lens (IOL) dislocation after IOL implantation in Chinese Han populations. Methods The medical records of patients with IOL dislocation were retrospectively reviewed from January 2007 to December 2017, and a total of 312 patients (male: 231, female: 97) (328 eyes) were included in this study. The axial length (AL), IOL power, and the time interval between cataract surgery and IOL dislocation as well as the ocular conditions associated with IOL dislocation were recorded. The IOL dislocation was classified and graded based on its relationship with the capsule and the position of the dislocated IOL. Results The mean time between original cataract surgery and IOL dislocation was 5.63 ± 5.13 years; IOL dislocation occurred in up to 56.1% (184 eyes) of the eyes within 5 years. Trauma was found in 136 eyes (41.5%); pars plana vitrectomies were performed in 61 eyes (18.6%), and high myopia was detected in 108 eyes (32.9%). A total of 243 eyes (74.1%) had out-of-the-bag IOL dislocations, while 85 eyes (25.9%) had in-the-bag IOL dislocations. There was a statistically significant difference in the constituent ratio of trauma between in-the-bag dislocation and out-of-the-bag dislocation (Pearson's chi2 = 33.3992, P < 0.001); ocular blunt traumas were significantly higher in in-the-bag dislocations, while open-globe injuries were significantly higher in out-of-the-bag dislocations. A statistically significant difference was found for the ratio of patients with AL longer than 30 mm between in-the-bag dislocation and out-of-the-bag dislocation (Pearson's chi2 = 9.7355, P < 0.002). Conclusions In Chinese Han populations, the most common IOL dislocation is out-of-the-bag dislocation; the most common risk factors were trauma, long axial length, and eyes undergoing pars plana vitrectomy; a minimum follow-up of 5 years is suggested for IOL dislocation-predisposed eyes undergoing cataract surgery.

Highlights

Dislocation of an intraocular lens (IOL) is uncommon but is one of the most serious complications following cataract surgery [1]
Based on whether or not the dislocated IOL is in the capsule, it can be classified into two categories: in-the-bag dislocation and out-of-the-bag dislocation; it can be classified as dislocation in the anterior chamber, in the posterior chamber and/or in the anterior vitreous cavity, and in the deep vitreous cavity, relying on the sites of dislocated IOL
A total of 312 patients (328 eyes, 16 patients had bilateral IOL dislocations) were included in this study, with a mean age of 48.10 ± 20.17 years, ranging from 2 to 85 years (Table 1). e included patients had an average time from cataract surgery to the onset of IOL dislocation of 5.63 ± 5.13 years (1 day to 23.39 years, Table 1), with 56.1% (184 eyes) occurring within 5 years, 35.1% (115 eyes) between 5 and 10 years, and 8.8% (29 eyes) in more than 10 years (Figure 1(a))

Summary

Introduction

Dislocation of an intraocular lens (IOL) is uncommon but is one of the most serious complications following cataract surgery [1]. It is a cause of blindness throughout the world, with an incidence of 0.05–3% [2,3,4] and a cumulative risk of 0.1% after 10 years and 1.7% after 25 years following cataract surgery [5]. 48.10 ± 20.17 years 5.63 ± 5.13 years 0.53 ± 1.40 years. Range 2 to 85 years 1 day to 23.39 years 1 day to 15.39 years 17.74 to 36.69 mm 20.86 to 35.86 mm 17.74 to 36.69 mm 29 eyes 8.8% 115 eyes 35.1%. Age Duration of IOL dislocation Time between IOL dislocation and surgical intervention Axial length In-the-bag dislocation Out-of-the-bag dislocation Mean ± SD

Methods

Results

Conclusion