Abstract
Purpose
To report the predisposing factors and surgical outcomes of intraocular lens dislocation (IOL) after phacoemulsification.
Methods
We performed a retrospective study of 131 eyes in 120 patients who were diagnosed with IOL dislocation after phacoe-mulsification between January 2008 and December 2013. The main outcomes are possible predisposing factors, characteristics of IOL dislocation, and outcomes of rectification surgery, including visual acuity (VA), and refractive status before and at 3 months after surgery.
Results
The main conditions associated with IOL dislocation were as follows: status after vitrectomy (27.5%), long axial length (9.2%), neodymium-doped yttrium aluminium garnet (Nd:YAG) posterior capsulotomy (8.4%), uveitis (6.1%), trauma (5.3%), mature cataract (3.8%), and pseudoexfoliation (2.3%). Mean uncorrected VA improved significantly after rectification surgery ( p = 0.00), and best-corrected VA also improved significantly ( p = 0.01). Mean value of spherical equivalent tended to decrease, al-though the decrease was not significant ( p = 0.07). Whereas astigmatism showed a significant increase ( p = 0.01). 6 eyes (4.6%) were associated with recurrence of IOL dislocation.
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Table 1.
Characteristics of patients with intraocular lens dis-location
Total number of included eyes | 131 |
Ages at time of rectification surgery (years, range) | 60.6 ± 11.7 (24-91) |
Ages at time of cataract surgery (years, range) | 52.6 ± 13.5 (19-88) |
Male (%) | 110 (84.0) |
Laterality (OD/OS) | 66/65 |
Interval* (months, range) | 89.6 ± 64.7 (0-238) |
Axial length (mm) | 24.6 ± 2.2 |
Underlying medical condition | |
Diabetes mellitus (%) | 40 (30.5) |
Hypertension (%) | 56 (42.8) |
Previous cataract surgery (n, %) | |
At our medical center | 66 (50.4) |
At other hospital | 65 (49.6) |
Table 2.
Site and type of intraocular lens dislocation
Table 3.
Material and design of dislocated IOL
Data | ||
---|---|---|
Material of IOL (N = 131) | ||
Acryl | 67 (51.1%) | |
PMMA | 7 (5.3%) | |
Silicone | 5 (3.8%) | |
Hydrogel | 1 (0.8%) | |
NA | 51 (38.9%) | |
Design of IOL (N = 131) | ||
One-piece | 40 (30.5%) | |
Three-piece | 80 (61.1%) | |
Others* | 1 (0.8%) | |
NA | 10 (7.6%) |
Table 4.
Possible predisposing factors for intraocular lens dis-location
Predisposing factor (N = 131) | Eyes (%) |
---|---|
Status after vitrectomy | 36 (27.5%) |
Long axial length* | 12 (9.2%) |
Nd:YAG posterior capsulotomy | 11 (8.4%) |
Uveitis | 8 (6.1%) |
Trauma | 7 (5.3%) |
Mature cataract | 5 (3.8%) |
Pseudoexfoliation | 3 (2.3%) |
Table 5.
Comparison of predisposing factors between In-the-bag and Out-of-the-bag dislocation (N = 66)
Predisposing factor | In-the-bag (N = 49) | Out-of-the-bag (N = 17) | p-value† |
---|---|---|---|
Status after vitrectomy Long axial length* | 14 (28.6%) 5 (10.2%) | 5 (29.4%) 1 (5.9%) | 1.00 1.00 |
Nd:YAG posterior capsulotomy | 4 (8.2%) | 1 (5.9%) | 1.00 |
Uveitis | 5 (10.2%) | 0 (0.0%) | 0.32 |
Trauma | 1 (2.0%) | 2 (11.8%) | 0.16 |
Mature cataract | 2 (4.1%) | 0 (0.0%) | 1.00 |
Pseudoexfoliation | 1 (2.0%) | 0 (0.0%) | 1.00 |
Posterior capsular rupture | 6 (12.2%) | 8 (47.1%) | 0.00 |
Table 6.
Surgical outcomes of rectification surgery after intraocular lens dislocation (N = 131)
Pre-op | 3 months post-op | p-value* | |
---|---|---|---|
UCVA (log MAR) | 1.23 ± 0.78 | 0.60 ± 0.60 | 0.00 |
BCVA (log MAR) | 0.50 ± 0.69 | 0.37 ± 0.63 | 0.01 |
SE (diopter) | +2.76 ± 6.00 | -0.40 ± 1.21 | 0.07 |
Astigmatism (diopter) | -0.82 ± 0.97 | -1.41 ± 1.01 | 0.01 |