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Retinal detachment after bag-in-the-lens intraocular lens implantation

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Session Details

Session Title: Cataract Surgery Complications

Session Date/Time: Monday 15/09/2014 | 08:00-10:30

Paper Time: 09:51

Venue: Boulevard A

First Author: : J.Van Looveren BELGIUM

Co Author(s): :    K. Boven   J. Van den Heurck   D. Mathysen   M. Tassignon     

Abstract Details


To determine the incidence of pseudophakic retinal detachment (PRD) after phakoemulsification followed by the bag-in-the-lens (BIL) intraocular lens (IOL) implantation technique which necessitates a primary posterior continuous circular capsulorhexis (PPCCC) and to assess the factors of increased risk.


Antwerp University Hospital, Department of Ophthalmology Antwerp University, Faculty of Medicine


All BIL IOL implantations performed in our hospital over a 7-year period were retrospectively reviewed. We excluded BIL IOL implantations when they were part of a combined surgery or part of an IOL exchange procedure. The following data were recorded: gender, age, medical history, refractive state, axial length, IOL power, date of surgery and of postoperative visits, peroperative complications and occurrence of PRD. A Cox regression analysis was performed assessing the incidence of postoperative PRD and its risk factors.


1387 BIL IOL implantation procedures fulfilled the inclusion criteria. In 46 cases there was a history of PRD in the contralateral eye. 680 cases had an axial length exceeding 24mm. Mean age at time of surgery was 65 years. Peroperative complications occurred in 21 cases. There was a mean follow-up time of 44.69 months. During follow-up a PRD occurred in 19 patients (1.37%). An increased risk was found with male gender, increasing axial length, a history of PRD in the fellow eye and a history of eye trauma.


The BIL IOL implantation technique is an innovative technique in cataract surgery and although it is more demanding peroperatively because it necessitates a PPCCC it is a well-controlled and safe surgical technique when performed correctly giving much postoperative advantages. Little is known about the influence of a PPCCC on the incidence of PRD. In these series 19 out of 1387 eyes (1.37%) developed a retinal detachment after phakoemulsification and BIL IOL implantation after a mean follow-up of 44.69 months. These results are within an acceptable range for PRD after phakoemulsification, especially when taking into account our patient population comprising many referred high-risk patients. Important risk factors for PRD after phakoemulsification known in literature remain associated with an increased risk for retinal detachment when using the BIL IOL implantation technique, including: male gender, higher axial length and history of eye trauma or PRD in the contralateral eye.

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