Managing Cases of Dislocated Intraocular Lenses; a Retrospective Review of Cases over a 13 Year Period

Abstract

Purpose: To report the incidence and outcomes over 13 years of managing cases of dislocated intraocular lens implants (PCIOL) Setting: St Thomas’s Hospital, London UK Design: Retrospective case series Methods: Clinical data of 40 patients on the VITREOR database were analyzed to determine pre-operative clinical findings, surgical methods and post operative outcomes. Results: The average age of the patients was 70 years and 60% were male. 24 cases were spontaneous late PCIOL dislocations, 13 were referred directly following complicated cataract surgery and 3 were post blunt trauma. The average post operative visual acuity for all patients was 0.65 LogMAR, 0.46 LogMAR in patients managed with an anterior chamber intraocular lens (ACIOL) and 0.25 LogMAR in the those manage with a posterior scleral fixated lens (PSFL). The number of patients with dislocated IOLs as a proportion of total operations performed by the Vitreoretinal service was significantly higher (0.8% of all surgical cases) in the last 6.5 years of data collection than the first 6.5 years (0.2% of all surgical cases) (p= 0.0036). Conclusion: There are several surgical options for correction of a dislocated PCIOL and none show obvious superiority. The incidence of dislocated PCIOLs appears to be increasing.