ESCRS - FP05 - RISK FACTORS AND IMPACT OF INTRAOCULAR LENS CHARACTERISTICS ON INTRAOCULAR LENS DISLOCATION AFTER CATARACT SURGERY – A POPULATION STUDY

RISK FACTORS AND IMPACT OF INTRAOCULAR LENS CHARACTERISTICS ON INTRAOCULAR LENS DISLOCATION AFTER CATARACT SURGERY – A POPULATION STUDY

Published 2022 - 26th ESCRS Winter Meeting

Reference: FP05 | Type: Abstracts | DOI: 10.82333/yg4q-8t96

Authors: Maximilian Gabriel* 1 , Christoph Mayer-Xanthaki 1 , Gudrun Pregartner 2 , Nino Hirnschall 3 , Thomas Falb 1 , Michael Sommer 1 , Oliver Findl 4 , Andreas Wedrich 1

1Department of Ophthalmology,Medical University Graz,Graz,Austria, 2Institute for Medical Informatics, Statistics and Documentation,Medical University Graz,Graz,Austria, 3Department of Ophthalmology,Kepler University Linz,Linz,Austria, 4Department of Ophthalmology,VIROS - Vienna Institute for Research in Ocular Surgery, a Karl Landsteiner Institute, Hanusch Hospital, Vienna, Austria,Vienna,Austria

Purpose

To assess and identify risk factors including intraocular lens (IOL) characteristics on IOL dislocations after cataract surgery.

Setting

Retrospective cohort study.

Methods

Cox proportional-hazard regression models were used to assess the influence of risk factors including IOL characteristics on IOL dislocations. Patients that underwent cataract surgery at the Medical University Graz (Austria) between 1996 and 2017 were included.

Results

68 199 eyes of 46 632 patients (60.2% women, mean age: 73.71 SD±10.82 years) underwent uncomplicated phacoemulsification during the study period. 111 patients (0.16%) had in-the-bag (ITB) and 35 (0.05%) out-of-the-bag (OTB) dislocations. The adjusted hazard ratio (HR) associated with a higher risk for ITB dislocations was 5.09 (95% CI, 2.76 - 9.38) for weak zonula fibers, 14.36 (95% CI, 9.24 - 22.32) for pseudoexfoliation, 2.08 (95% CI, 1.38 – 3.14) for uveitis and 1.97 (95% CI, 1.38 – 2.83) for retinitis pigmentosa. Higher age (HR 0.97, 95% CI, 0.95 - 0.98) was associated with a lower risk. Hydrophilic IOLs (HR 2.35; 95% CI, 1.45 - 3.80), quadripode IOLs (HR 2.01; 95% CI, 1.04 – 3.86), and haptic angulation (HR 1.61, 95%, 1.04 - 2.48) were associated with a higher risk. A lower risk was observed for three-piece-IOLs (HR 0.58, 95% CI, 0.34 - 0.98) and larger overall IOL diameter (HR 0.79, 95% CI, 0.66 - 0.95). For OTB dislocations, the HR associated with a higher risk was 18.81 (95% CI, 5.84 - 60.58) for silicone IOLs, 2.12 (95% CI, 0.62 - 7.29) for hydrophilic and 3.39 (95% CI, 1.69 - 7.15) for male gender. Higher age (HR 0.97, 95% CI, 0.95 - 0.99) and larger overall IOL diameter (HR 0.40, 95% CI; 0.25 - 0.63) showed a lower risk.

Conclusion

This study provides a hierarchy of risk factors for ITB dislocations: Pseudoexfoliation, weak zonular fibers, hydrophilic IOLs, quadripode IOLs, and haptic angulation. Three-piece IOLs and a larger overall diameter were associated with a lower risk. Risk factors for OTB dislocations were silicone IOLs, hydrophilic IOLs, male gender, a smaller overall IOL diameter and young age.