Abstract
The aim of this study was to evaluate possible risk factors for late intraocular lens (IOL) dislocation after routine cataract surgery. A retrospective analysis of medical records of all the patients who were treated in the university hospital between 2011 and 2012 for late IOL dislocation requiring surgical management after routine cataract surgery was performed. In total, 58 patients (58 eyes) were included into the study. The mean time between cataract surgery and late IOL dislocation was 67.8 months (SD, 34.9). A negative correlation was found between the patient age at cataract surgery and the time between cataract surgery and IOL dislocation (r=-0.29; P=0.042). Late in-the-bag dislocation occurred in 87.9% and late out-of-the-bag dislocation in 12.1% of the cases. Pseudoexfoliation was present in 56.9% and 42.9% of the eyes with in-the-bag and out-of-the-bag dislocation, respectively. The odds ratio for IOL dislocation within 43 months after complicated cataract surgery was 24.0 (95% confidence interval [95% CI] 4.5-127.4; P<0.001) and for in-the-bag IOL dislocation 24.9 (95% CI, 4.2-148.0; P<0.001). The odds ratio for in-the-bag IOL dislocation within 43 months after advanced cataract surgery was 18.8 (95% CI, 2.0-180.0; P=0.011). Moreover, in-the-bag IOL dislocation occurred earlier in the patients with past uveitis (P=0.020) or zonule laxity (P=0.037). Complicated cataract surgery increased the risk of both late in-the-bag and out-of-the-bag IOL dislocation, and advanced cataract increased the risk of late in-the-bag IOL dislocation. The time to in-the-bag IOL dislocation shortens with pseudoexfoliation syndrome, advanced age, or past uveitis. These factors must be taken into account while planning a postoperative follow-up.
Highlights
Cataract surgery is a safe surgical procedure with a high rate of success and has markedly improved because of development in surgical devices and intraocular lenses (IOLs), making it safer than it was 20 years ago
The odds ratio for IOL dislocation within 43 months after complicated cataract surgery was 24.0 (95% confidence interval [95% CI] 4.5–127.4; P
The odds ratio for in-the-bag IOL dislocation within 43 months after advanced cataract surgery was 18.8
Summary
Cataract surgery is a safe surgical procedure with a high rate of success and has markedly improved because of development in surgical devices and intraocular lenses (IOLs), making it safer than it was 20 years ago. The surgical complication rate is low: capsule rupture occurs in 1.9% to 5.2% and vitreous loss in 1.1% to 5.0% of cataract surgeries [1]. IOL dislocation is one of the most serious complications after cataract surgery. The causes of IOL dislocation are loss of capsular or zonular integrity during surgery or asymmetric placement of the haptics [2]. Most cases of IOL decentration present during the first weeks after cataract surgery with the incidence being between 0.2% and 2.8% [3]. A zonular rupture is believed to be a major cause of early IOL dislocation. The zonules may be damaged during cataract surgery due to posterior pressure on the lens or IOL implantation [4].
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