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Eileen Tonner, Mathew W MacCumber; Visual Results and Complications of Surgery for Dislocated Intraocular Lens. Invest. Ophthalmol. Vis. Sci. 2016;57(12):4468.
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© ARVO (1962-2015); The Authors (2016-present)
Dislocation of posterior chamber intraocular lens (IOL) is one of the most common complications of IOL implantation. The most common methods of PCIOL repositioning surgery include suturing the PCIOL to the ciliary sulcus, inserting a new anterior chamber (AC) IOL, suturing the PCIOL to the iris via McCannel sutures, and repositioning the PCIOL in the capsular bag without sutures. This study aims to report a retrospective analysis of a large series of eyes that underwent surgery for dislocated IOL to investigate predicting visual outcome, complication factors, and successful positioning without more surgeries.
We performed retrospective chart review of Illinois Retina Associates patients with dislocated Intraocular Lens surgeries between July 2007 and March 2014. The dislocated intraocular lens surgeries included repositioning IOL requiring an incision and also the surgeries that exchanged IOLs. All eyes were included that had at least one month follow up after surgery. Dislocated IOL surgery was performed by eight surgeons. 256 charts were identified for patients who underwent surgery for repositioning an IOL or exchanged an IOL in the Illinois Retina database. The total number of charts reviewed that were included in analysis was 125. The clinical data compiled from the charts included age, race, and gender. Preoperative information obtained included best corrected pinhole acuity, best corrected visual acuity, other preexisting ocular conditions prior to cataract surgery.
Results showed that at 6 months after surgery, ciliary sulcus fixation and AC IOL exchange methods had the best outcome on vision, both with a 5 line increase. Iris fixation had the worst outcome on vision of the four groups with one line decrease. At 12 months after surgery, the order of best outcome on vision was ciliary sulcus fixation (6 lines), AC IOL exchange (5 lines), reposition without sutures(3 lines), and then Iris fixation (1 line). Complications requiring a re-operation occurred in 0% of the AC IOL exchange eyes, 8.7% of the Iris fixated eyes, 23.8% of the ciliary sulcus fixation, and 25% in the IOL reposition eyes without sutures.
Regarding vision, the results suggest that the ciliary sulcus and AC methods are the best. Regarding the associated complications that need a second surgery, inserting an AC IOL is the best surgical approach.
This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.
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