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Surgical outcome of late in-the-bag intraocular lens dislocation treated with pars plana vitrectomy

Poster Details

First Author: A.Rey SPAIN

Co Author(s):    A. Dyrda   I. Jurgens   X. Maseras              

Abstract Details

Purpose:

To present the visual outcome and postoperative complications of pars plana vitrectomy (PPV) and intraocular lenses (IOL) removal with or without IOL exchange of late in-the-bag IOL dislocation after uneventful cataract surgery.

Setting:

Institut Catala de Retina (ICR), Barcelona, Spain

Methods:

Retrospective analysis of a consecutive series of 83 eyes with late in-the-bag dislocated IOL treated with PPV and anterior chamber (AC) IOL (25 eyes), transscleral suture-fixated posterior chamber (PC) IOL (38 eyes) or aphakia (20 eyes).

Results:

High myopia was the major predisposing factor (40%).The interval between cataract surgery and the dislocation was 10.9 years.The complication rate after the second surgery was 43%;being transient hypotony (19%) and hypertension (15%) the most frequent. Postoperative visual acuity (BCVA) improvement was statistically significant (p=0.001), with a mean of 3 Snellen lines. This improvement was also significant in two subgroups, patients with sutured PC IOL(20/80 to 20/40;p=0.001) and in patients with AC IOL(20/125 to 20/40;p=0.001). However,BCVA did not improve in aphakic patients(20/63 to 20/63;p=0.13). Postoperative astigmatism increased significantly(p=0.001), with a mean of -1D.Mean follow-up was 24 months.

Conclusions:

The major predisposing factor for late in-the-bag IOL dislocation is myopia. Despite a complication rate of 43%, mostly minor and transient, IOL exchange surgery is an effective procedure with a good visual outcome (mean 3 Snellen lines improvement). There were no statistically significant differences in the final BCVA or complication rate between AC IOL and sutured PC IOL, thus, both surgical techniques may be considered to treat this condition.

Financial Disclosure:

NONE

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