A complication of implantation of an intraocular lens (IOL) in the capsular bag is dislocation of the IOL, which can happen years after an uncomplicated cataract surgery.
While the 10-year cumulative incidence of dislocation thankfully is low, an estimated 0.5% to 1.0%, the frequency with which this occurs is sizable because of the high rate at which cataract surgeries are performed and the increased life expectancies of patients.
The average time between IOL implantation and dislocation is 7 to 10 years, Marius Dalby and colleagues pointed out. The notable culprits that are involved in IOL dislocation are pseudoexfoliation, high myopia, and previous vitrectomy.
To date, investigators have not reached a consensus on how to address the problem of a dislocated IOL. IOL repositioning was evaluated in one prospective study that included in-the-bag and out-of-the bag cases of dislocations with the findings of satisfactory improvement in vision and low complication rates, but the study considered a mean follow-up period of only 17 months (range, 1-55 months).
Because no information regarding long-term follow-up was available, Dr. Dalby and associates undertook a clinical trial to evaluate the long-term follow-up of patients with late in-the-bag IOL dislocations. The investigators compared scleral repositioning of the IOL with IOL exchange with a new iris-claw IOL being substituted for the original lens. The main study outcomes were the distance-corrected visual acuity (DCVA) and long-term complications at the two-year time point.
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