Management and outcomes of intraocular lens dislocation in patients with pseudoexfoliation

Abstract

To analyze the outcomes of surgery for dislocated intraocular lenses (IOLs) in patients with pseudoexfoliation (PXF). Private practice, Boston, Massachusetts, USA. Retrospective case study. Eyes with PXF and IOL dislocations that had IOL exchange or repositioning were reviewed. An outcomes analysis compared the surgical techniques with regard to corrected distance visual acuity (CDVA), intraocular pressure (IOP), and glaucoma medication requirements. The IOL exchange was performed in 64 eyes (79%) and IOL repositioning in 17 eyes (21%). The CDVA improved in all eyes, from a preoperative mean of 0.78 logMAR ± 0.50 (SD) to a mean of 0.35 ± 0.31 logMAR at the final follow-up (mean 2.5 ± 2.6 years) (P<.0001). The mean IOP was reduced by 4.2 mm Hg at the final follow-up (P<.0001). The mean glaucoma medication requirement remained stable at the final follow-up compared with the preoperative levels (P>.05). There were no significant differences in the mean CDVA, IOP, or glaucoma medication requirement between eyes that had IOL exchange and eyes that had IOL repositioning. There were no significant intraoperative complications. The most common postoperative complication was a transient decrease in IOP to 5 mm Hg or lower or an increase in IOP to 30 mm Hg or higher. Patients with PXF having surgical treatment of IOL dislocation have the potential for excellent visual outcomes with minimal intraoperative and postoperative complications. No author has a financial or proprietary interest in any material or method mentioned.