Incidence And Long-Term Complications Of Intraocular Lens Dislocation After Cataract Surgery In South Korea: A 20-Year Nationwide Cohort Study.

To investigate the incidence and long-term complications of intraocular lens dislocation after cataract surgery in South Korea.

A retrospective cohort study

A retrospective nationwide cohort study was performed based on national health claim data recorded in the Korean National Health Insurance Service database. We identified pseudophakic patients who underwent secondary intraocular lens implantation surgery from 2002 to 2021 in Korea using Korean Electronic Data Interchange (KEDI) code and Korean Classification of Diseases (KCD)-7 code. Incidence rates per 1,000,000 person-years and 20-year cumulative risks were calculated, and multivariate analysis was performed to determine significant risk factors.

Among 4,848,125 pseudophakic patients, 39,965 (0.82%) experienced IOL dislocation requiring surgical intervention between 2002 and 2021, with a higher incidence in younger and male patients. The incidence of IOL dislocation requiring surgery in pseudophakic patients was 28,900/1,000,000 person-years (95% CI: 28,431–29,369). The 20-year cumulative incidence of RD after secondary IOL implantation was 5.9%, with increased risk in younger patients (<40 years: 10.6%) and males (adjusted HR: 1.54, 95% CI 1.376–1.725). The 20-year risk of BK was 13.0% after secondary IOL implantation, with significant risk factors including older age, female gender, lower socioeconomic status, and urban residency.

Younger age and male gender were associated with a higher risk of IOL dislocation and RD, while BK was more prevalent in older patients, females, and those with lower socioeconomic status. These findings highlight the need for targeted postoperative surveillance and management strategies to mitigate complications in high-risk pseudophakic populations.