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K. Julian, S. Cayette, B. Bodaghi, P. LeHoang, N. Cassoux; Late In-The-Bag Spontaneous Intraocular Lens Dislocation in Patients With Uveitis. Invest. Ophthalmol. Vis. Sci. 2010;51(13):4571.
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to describe the ocurrence of late in-the-bag spontaneous intraocular lens (IOL) dislocation in patients with uveitis.
retrospective, observational case series. Medical records of uveitic patients who underwent IOL explantation surgery between January 2007 and November 2009 were reviewed. Patients with concomitant pseudoexfoliation (PEX) syndrome or history of trauma were excluded.
eight eyes from seven patients (F:M 3:4; mean age 48 year-old) underwent explantation surgery for spontaneous late dislocation of the entire capsular bag containing the IOL. Underlying uveitic entities were Behcet disease (n=2), cytomegalovirus retinitis (n=2), tuberculosis (n=2), herpes simplex virus retinitis (n=1) and Fuchs syndrome (n=1). Mean time from uneventful cataract surgery to spontaneous IOL dislocation diagnosis was 76.75 months (53-125 months). All IOLs were acrylic, 3-piece, open loop, foldable lenses: 4 Alcon MA60BM Acrysof, 2 Alcon MA50BM Acrysof (Alcon Inc, Fort Worth, Texas, USA) and 2 Sensar AR40 (Advanced Medical Optics, AMO). No eye had an associated capsular tension ring. Four eyes had undergone posterior Nd-Yag laser capsulotomy before dislocation; mean time from capsulotomy to dislocation diagnosis was 64.25 months (25-105). Bilateral in-the-bag dislocation ocurred in one patient with tuberculous uveitis. One eye had undergone intravitreal implantation of the sustained release ganciclovir device 128 months (10 years, 8 months) before dislocation and another one had undergone pars plana vitrectomy 77 months (6 years, 5 months) before dislocation; both cases suffered from CMV retinitis.
patients with uveitis are at risk for delayed spontaneous in-the-bag IOL dislocation after uncomplicated cataract surgery. Zonular insuffiency is the final common cause leading to this complication and may be related to the inflammation itself.
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